Experts warn against stigma as WHO declares Monkeypox a public health emergency

Experts from India ask states to be alert, trace and track the virus but not stigmatise people or create panic.

ByChetana Belagere

Published Jul 23, 2022 | 9:11 PMUpdatedJul 29, 2022 | 10:51 AM

WHO Cheif

Even as the World Health Organisation (WHO) declared Monkeypox a global health emergency on Saturday, 23 July, experts in India urged people not to stigmatise people based on it, and instead asked for more preparedness.

The announcement means that the WHO now sees the outbreak as an “extraordinary” situation, one that is significant enough to be considered a threat to global health and requires a combined effort from all the countries to contain the spread of the disease.

“The virus has now spread to 75 countries, and every day is spreading to other countries, and this announcement we feel will give solidarity, coordination from all the countries and help in controlling the spread globally,” WHO Director-General Tedros Adhanom Ghebreyesus said in Geneva on Saturday.

He explained that though the WHO’s emergency committee members could not reach a consensus on the issue, it was the truth that the outbreak had spread rapidly to 75 countries through new modes of transmission, and that needs further investigations and research.

So far, more than 16,000 cases have been reported across 75 countries — including three from Kerala in South India. It was noted that the number of confirmed infections increased 77% from late June through early July.

High incidence in MSM community

The WHO said Monkeypox was spreading primarily in the gay community — among men who have sex with men (MSM).

The WHO’s top Monkeypox expert, Dr Rosamund Lewis said that around 99 percent of all the cases beyond Africa were in men, and that among those, 98 percent involved men who have sex with men.

“However, it is not limited to the gay community and can spread to anyone, regardless of sexual orientation,” she said.

It can be noted that two children were diagnosed with Monkeypox in the US on Saturday.

The experts said this was the first time during this outbreak that this happened, with household transmission cited as the cause.

The WHO also stressed that countries should ensure that no particular section of any community is stigmatized.

Nations have been asked to engage and protect the affected communities, intensify their disease surveillance and public-health measures, strengthen the clinical management in hospitals, and inform clinics and doctors on identifying and treating Monkeypox symptoms

They have also been urged to speed up research into the use of vaccines and treatment options for the disease, as well as not to hoard the available vaccines.

Explaining the reason for the spread of Monkeypox, the Indian Medical Association (IMA) Covid-19 task force co-chair Dr Rajeev Jayadevan told South First that it was not always easy for experts to agree on classifying diseases to fit predetermined definitions, such as Public Health Emergency of International Concern, and that it was understandable that the WHO’s latest announcement was not unanimous.

He explained, “Monkeypox has spread primarily through sexual networks involving only men, no doubt amplified by super-spreading events in some of these countries where thousands of men with multiple sex partners congregated.”

Jayadevan added: “These individuals then carried the infection to their own networks in their respective countries. When a large number of such men are affected, the disease will slowly percolate to other subgroups, such as women and children.”

‘Do not panic, but be prepared’

Experts from India stressed that though there was no reason to panic over the announcement, governments need to create awareness and ensure contact tracing happens to the fullest to keep the disease under control.

“Contact tracing plays a key role in monitoring the disease. The ability to detect, test, and trace should be a priority of all state governments now. Though Monkeypox can be transited by the respiratory route, the mode of spread is very minimal,” explained Dr Gagandeep Kang, a microbiologist at CMC Vellore.

Explaining the WHO’s decision was obviously not a simple one, Dr Giridhara R Babu, a noted epidemiologist from Karnataka, told South First, “This wasn’t obviously a simple process, as there were differing views ahead of reaching this decision. This might have been necessitated as the disease is spreading faster in newer areas of the world.”

He added that the declaration of emergency could help control the spread swiftly, and hopefully provide a window to better understand the disease.

“It is important to build global resources to strengthen the implementation of international health regulations,” he said.

Meanwhile, Jayadevan said the type of Monkeypox spreading in Western nations was neither lethal like Covid-19 nor of great risk to the general population.

“Early and effective intervention should have been made along all of these sexual networks to halt it’s spread. This announcement might get preventive measures more attention and acceptance,” he explained.

‘Do not stigmatise’

The WHO stressed the need to not stigmatise any particular community, but instead take them into confidence and create awareness amongst them.

Gay rights activist Akkai Padmsali from Karnataka said, “It would be a crime for any government or people to do that. It is definitely against medical health policies.”

She told South First: “There is no point in targeting marginalised communities. We have to work with them and the government needs to start educating and creating awareness about the disease. Covid-19 has already shattered us. We cannot handle another blow.”

Meanwhile, Babu stressed that it was definitely not a case of only the gay community being at risk.

“Any human being with skin-to-skin contact is at risk. It is the close contact with skin lesions that is most risky, followed by exposure for a longer time in closed spaces (respiratory route),” he explained.