By Echey Ijezie
Even after the novel coronavirus exposed glaring flaws in the world’s collective ability to respond to infectious disease outbreaks, we are seemingly back to the old ways, as evidenced by the global response to the now endemic monkeypox.
The world may once again lose a chance to control a pandemic. The zoonotic viral disease, which is already endemic in 10 countries in West and Central Africa, only drew the world’s attention after affecting people in rich countries in the Global North.
Even
after the disruption caused by Covid-19, wealthy countries’ self-destructive
unwillingness to cooperate for the benefit of the entire global population is
evident again.
This year, there have been dozens of monkeypox cases in Cameroon, Nigeria, and the Central African Republic (CAR), with the Democratic Republic of the Congo (DRC) reporting the highest number of infections with over 2,938 cases and 110 deaths.
As of Sep. 9, the Africa Centres for Disease Control and
Prevention (A-CDC) reported 4,244 total cases (520 confirmed, 3,724 suspected)
and 124 deaths.
There are nearly 58,000 cases globally, with 125 countries
reporting at least one case. African health officials still face the challenge
of undercounting due to limited surveillance and testing capacity, which
explains the vast discrepancy between confirmed and suspected cases.
Additionally, the absence of vaccines for front-line health care
workers and laboratory technicians in affected countries puts them in imminent
danger. In July of this year, the World Health Organization (WHO) designated
the global monkeypox outbreak a public health emergency of international
concern (PHEIC).
Researchers
in Africa had hoped that the declaration—the highest alarm by WHO outside of a
pandemic—would alert the world to support Africa’s fight against the disease.
Sadly, that has not been the case.
The WHO PHEIC label means that a coordinated international
response is needed to unlock funding and global efforts to collaborate on
sharing vaccines, technologies, and treatments. Researchers and health
officials in Africa are wary that, as with the Covid-19 vaccine apartheid
against African countries, the continent will continue to be sidelined in its
bid to secure enough vaccines.
To date, though WHO member states have pledged more than 31
million smallpox vaccine doses to the global body for smallpox emergencies —
these vaccines have never been shared with Africa for use against monkeypox.
Monkeypox is transmitted to humans through contact with infected animals’
blood, bodily fluids, or cutaneous or mucosal lesions.
Infections in humans occur by handling infected monkeys, Gambian
giant rats, and squirrels, with rodents the most likely reservoirs of the
virus. The current outbreak is the largest in history outside of Africa, and
human-to-human cases primarily occur among men who have sex with men.
Symptoms include fever, intense headache, swelling of the lymph
nodes, back pain, muscle ache and, lack of energy. There could be skin rashes
that begin on the face and spread to other parts of the body [including the
genitals] and evolve to pustules and crusts, according to A-CDC.
Scientists have identified the existence of two known virus
strains in the endemic regions in Africa, with the Congo Basin showing more
lethality with a mortality rate of up to 11% in some of the outbreaks.
According to WHO, the monkeypox fatality rate is typically 3-to-6%.
The WHO reports that monkeypox appears more common in squirrel,
rat, and shrew species, occasionally spilling over into the human population,
spreading mainly through close contact. Isolating infected people typically
helps limit transmission. WHO also indicates that the vaccine against smallpox,
a far deadlier and more transmissible virus, also protects against monkeypox.
But
the world stopped using it in the 1970s, shortly before smallpox was declared
eradicated. However, wealthy nations still hold stockpiles of smallpox
vaccines, which have been used in the UK, US, France, and Canada to protect
people who have come in close contact with monkeypox patients, but few
lower-income countries have vaccine access.
There is now a seemingly concerted global response that has seen
vaccines distributed in some countries after confirmed cases of the disease in
Portugal, Spain, the U.S., and the UK.
However, Africa is so far in for another episode of unconscionable
vaccine apartheid in its fight against this latest monkeypox outbreak due to
vaccine hoarding by wealthy countries.
Accordingly, another opportunity presents itself for African
leaders to amplify their voices in a combined effort to demand that G20 leaders
prioritize global vaccine access for all nations, particularly developing
countries, when faced with a disease that has the potential to be endemic
globally.
*Dr.
Ijezie, country programme director, AIDS Healthcare Foundation (AHF Nigeria).
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