“Their lives are more valuable than us”: African experts blame the global reaction to monkeypox

World Health Organization (WHO) Director Tedros Adhanom Ghebreyesus Officially declared monkeypox Public health emergency (PHEIC) of international concern. This decision was made by the World Health Organization’s International Health Regulations Emergency Committee on the disease. End of second meeting In less than a month. According to the WHO, between meetings, the number of cases confirmed worldwide increased from 3,040 in 47 countries to more than 16,000 in 75 countries and territories, and the number of deaths increased from 1 to 5. did.

Prior to the declaration of PHEIC, WHO Africa Regional Director Matshidiso Moeti said: Scientific American Its early actions would have spurred countries to pay more attention to the disease in order to assess risk and better prepare. She added that African countries, where monkeypox has been endemic for decades, will have more money and resources available to combat the disease.

Earlier declarations “may cause additional attention from all countries and the availability and allocation of additional resources at the global level that may be available to African countries,” Moetti said. Stated. “It imposes obligations on some entities that control some of the tools available to provide support.”

But I don’t think Tedros is too late. In his PHEIC Declaration, he said, “With the tools we currently have, we can stop the infection and control this outbreak.”

In the Democratic Republic of the Congo (DRC), additional resources could help expand response efforts to many states with suspected cases but not supported by current partners, the DRC’s National Veterinarians said. Justin Masum, Dean of the Faculty, said. University of Education.

Moeti Scientific American WHO is working with African countries to provide all available support. However, Christian Happi, director of the African Infectious Diseases Genomics Center, disagrees with some aspects of WHO’s response to the outbreak of monkeypox and says it is shameful. According to him, there was no talk of using the world stockpile of smallpox vaccine for monkeypox when cases were reported only in African countries.

“But today [now] What they have [monkeypox] On the Global North issue, they are now mobilizing things, and that’s a shame [for] WHO does that, “he says.

According to a WHO spokesperson, the organization “continues to work closely with the Ministry of Health and the Institute Network in the African region, including countries such as Nigeria and the Democratic Republic that have reported cases of monkeypox in the last few years. We are supporting. Republic of Congo, Republic of Central Africa, Cameroon. “

Stretched finite resource

In Nigeria Monkeypox reappeared in 2017 after nearly 40 years of unidentified cases.. The number of confirmed cases in Japan decreased from 88 cases, which was the peak before 2017, to only 8 cases in 2020, but as of July 17, 2022, the number of cases has reached 117 cases. increase. according to Nigeria Centers for Disease Control and Prevention (NCDC).

NCDC Secretary Ifedayo Adettifa states that the Nigerian government has begun an emergency response to the current outbreak of monkeypox and has been monitoring it since 2017. However, it acknowledges that limited resources pose challenges to the country’s ability to respond to multiple disease outbreaks at the same time. “We have limited and limited resources, all of which are competing with different priorities,” says Adettifa. “We continue to deal with everything from Lassa fever, cholera, measles, yellow fever, monkeypox, and more. [and] COVID-If necessary, no matter what the headline is focused on, “he says.

Gap test

Some African countries continue to provide daily updates on the status of the COVID pandemic. However, such updates are not available for monkeypox. The main reason for this is the gap in the number of suspicious and confirmed cases. From January 1st to July 8th A total of 2,087 suspected monkeypox cases on the continent, Only 203 of them were confirmed. This large gap is due to a lack of components such as test kits and reagents.

“All African countries have the polymerase chain reaction system needed to test monkeypox, but many lack reagents and in some cases specimens, thanks to the enhanced laboratory capabilities as a result of COVID-19. We train in collection, handling and inspection, “he told Moeti Scientific American. She said WHO is working to secure 60,000 tests in Africa, of which about 2,000 tests and reagents will be shipped to high-risk countries such as the Democratic Republic of the Congo. Approximately 80 percent of suspected cases on the continent..

Masumu states that the true magnitude of monkeypox outbreaks in the DRC is not yet known due to inadequate testing. “The truth is that what we know is not reality,” he says. “We don’t analyze all suspicious samples. There should be many more unrecorded cases in this area.”

Vaccine injustice

Critics emphasized Unfairness in the distribution of COVID vaccine One of the reasons for the low penetration rate in Africa. According to the Africa Centers for Disease Control and Prevention (Africa CDC), a similar trend has already occurred in the distribution of smallpox vaccines that also protect against monkeypox.

Moeti said that if PHEIC had been declared earlier, African countries would have had access to additional tools, including unapproved vaccines for the disease. However, Ahmed Ogwell Ouma, acting director of the Africa CDC, revealed at a press conference on July 21 that there are no doses of smallpox vaccine on the continent.

In contrast, the U.S. government Already distributed More than 191,000 vaccinations in response to monkeypox. Added on July 15th 131,000 times The Bavarian Nordic JYNNEOS monkeypox vaccine has been added to the stockpile and is expected to receive an additional 786,000 doses by the end of the month. The country also acts on monkeypox but has side effects and should not be used in people with immunodeficiency. About 100 million doses of ACAM2000, a Food and Drug Administration-approved vaccine for smallpox. I have. ( US reaction to monkeypox However, it is not perfect. )

Similar vaccination rollouts are currently underway in the United Kingdom. Won An additional 100,000 vaccine doses to continue the selective vaccine strategy — “Infection in a subset of high-risk individuals, “According to the British Department of Health and Security. This includes gay, bisexual, or other men who have sex with men.

The happi coat said that a swift state of emergency, backed by a holistic approach to tackle the disease everywhere, was a sound public health strategy, but current injustice puts the world’s health at even greater risk. Insist.

“Our lives are not the same. Their lives are more valuable than us,” Happi said, referring to people in African countries and people in wealthy Western countries. “But unfortunately for them you are yourself [only] Ignoring some other people, you will continue to have the illness in your backyard, you will continue to suffer from it. If it happens anywhere, it should be relevant to the whole world. [which is] It’s not how they treat it now. “

Overall picture

The happi coat believes that the current impasse requires Africa to rally behind the Africa CDC to meet the public health emergency response needs of the African continent. “The reason people are considering Africa CDC is [the agency is] Very practical. [It’s] It’s very influential, “he says.

The Executive Council of the African Union agrees.At a recent meeting, it was Recruitment An amended Act on the African CDC that authorizes health agencies to declare public health emergencies of continental security concerns, even if WHO has not declared PHEIC. WHO Pushed back first This amendment is due to concerns that such a declaration could result in travel restrictions similar to previous travel bans. publication South africa Genome Surveillance Network First Reported An omicron variant of SARS-CoV-2, the causative virus of COVID-19.

Similarly, Karim Tunkara, Africa Regional Representative for the World Organization for Animal Health, said African countries need to prioritize prevention to improve their response to monkeypox and other zoonotic diseases. I am. And this correlates human, animal and environmental health, Pay more attention For wildlife surveillance to prevent future outbreaks.

“We encourage all countries to do everything possible to strengthen their capacity for early detection and early response,” says Tounkara. In addition to improving inter-population testing, he says, attention should be paid to strengthening the capabilities of the Veterinary Diagnostic Institute as “it is always better to tackle diseases from animal sources”.