LONDON (AP) – As the World Health Organization convenes its emergency committee on Thursday to consider whether the rising monkeypox outbreak justifies a global emergency, some experts say the WHO’s decision to act only after the disease has penetrated the West faces the grotesque injustices could anchor that sprang up between rich and poor countries during the coronavirus pandemic.
Declaring monkeypox a global emergency would mean that the UN health agency considers the outbreak an “extraordinary event” and puts the disease at risk of spreading across even more borders. It would also give monkey pox the same distinction as the COVID-19 pandemic and the ongoing efforts to eradicate polio.
Many scientists doubt that such a statement would help curb the epidemic, as the developed countries registering the most recent cases are quickly taking action to stop the epidemic.
Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mainly in Europe, as “unusual and worrying”. Monkeypox has been making people sick for decades in Central and West Africa, where one version of the disease kills up to 10% of people. No deaths have been reported so far from the epidemic outside of Africa.
“If the WHO was really concerned about the spread of monkeypox, they could have convened their emergency committee years ago when it resurfaced in Nigeria in 2017 and nobody knew why we were suddenly getting hundreds of cases,” said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. “It’s kind of curious that the WHO only called their experts when the disease started showing up in white countries,” he said.
Until last month, monkeypox had not caused any major outbreaks outside of Africa. Scientists have found no major genetic changes in the virus, and a leading WHO adviser said last month that the surge in cases in Europe is likely linked to sexual activity among gay and bisexual men at two raves in Spain and Belgium.
To date, the US Centers for Disease Control and Prevention have: confirmed more than 3,300 cases of monkeypox in 42 countries where the virus is typically not seen. More than 80% of cases are in Europe. In the meantime, Africa has already seen more than 1,400 cases this year, including 62 deaths.
David Fidler, a senior fellow in global health at the Council on Foreign Relations, said the WHO’s renewed focus on monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries during COVID-19.
“There may be legitimate reasons why the WHO only sounded the alarm when monkeypox spread to rich countries, but to poor countries, that seems like a double standard,” Fidler said. He said the world community was still struggling to ensure the world’s poor were vaccinated against the coronavirus and it was unclear whether Africans even wanted monkey pox vaccines, given competing priorities such as malaria and HIV.
“Unless African governments specifically ask for vaccines, it might be a little patronizing to send them because it’s in the West’s best interest to stop monkeypox exports,” Fidler said.
WHO has also proposed to vaccine sharing mechanism to help affected countries, who could see doses going to rich countries like Britain, which has the largest monkeypox outbreak outside of Africa — and recently widened the use of vaccines.
To date, the vast majority of cases in Europe have been in men who are gay, bisexual, or other men who have sex with men, but scientists warn that anyone who comes into close contact with an infected person or their clothing or bedding are at risk of infection regardless of their sexual orientation. People with monkeypox often experience symptoms such as fever, body aches, and rash; most recover within weeks without needing medical attention.
Even if the WHO announces that monkeypox is a global emergency, it’s unclear what impact that could have.
In January 2020, the WHO declared COVID-19 an international emergency. Few countries noticed until March, when the organization described it as a pandemic, weeks after many other authorities had done so. The WHO was later criticized for its multiple missteps during the pandemic, which some experts said could lead to a faster response to monkeypox.
“After COVID, the WHO doesn’t want to be the last to declare monkeypox an emergency,” said Amanda Glassman, executive vice president of the Center for Global Development. “This may not reach the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed.”
Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said the WHO and others should do more to stop monkeypox in Africa and elsewhere, but was not convinced a global emergency statement would help.
“There is a misguided idea that Africa is this poor, helpless continent, when in fact we know how to deal with epidemics,” Abdool Karim said. He said stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education.
“Maybe in Europe they need vaccines to stop monkeypox, but here we have been able to control it with very simple measures,” he said.