Governments should work with affected communities to promote accurate, non-stigmatizing information about monkeypox and make testing and treatment widely accessible, Human Rights Watch said today. As hundreds of cases are reported in Europe and North America, health authorities should draw on lessons from effective management in Africa, and prioritize global availability of vaccines, tests, and treatments.
Since an initial case in the current outbreak was reported on May 7, 2022 in the United Kingdom, 1,285 confirmed cases of monkeypox have been reported in Europe and North America, where monkeypox is not endemic, according to World Health Organization (WHO) data. This year, 1,536 suspected cases and 59 confirmed cases have been reported in seven of the eleven African countries where monkeypox is endemic. The WHO announced this week it is considering renaming the disease to avoid stigma.
“Clusters of monkeypox cases have put authorities in Europe and North America on high alert, and they should urgently engage at-risk communities in disseminating accurate information and supporting people to access testing and services,” said Kyle Knight, senior LGBT and health researcher at Human Rights Watch. “At the same time, global inequities in testing and treatments should be ended.”
Monkeypox is a viral disease that can spread from animals to humans and also between people through close contact with an infected person or objects such as bedsheets or clothing. Common symptoms include fever, swollen lymph nodes, pain when swallowing, pustules on the skin, and lesions around the genitals and anus. Outbreaks in endemic countries in recent years have been managed by information sharing, contract tracing, and isolation of suspected cases to prevent onward transmission.
At a media briefing on June 1, the WHO’s emergencies director, Dr. Mike Ryan, said, “We have a concern about this disease spreading in Europe but I certainly didn’t hear that same level of concern over the last 5 or10 years” since “there are thousands and thousands of cases of monkeypox every year in Africa and there are deaths every year.”
The WHO and some wealthy countries have stockpiles of smallpox vaccines, saved from when the disease was eradicated in 1980. The smallpox vaccine is effective against monkeypox. However, these vaccines are not currently available on the African continent; all that is currently available in Africa is an experimental drug. Experts have in recent weeks criticized these inequities. Dr. Matshidiso Moeti, WHO regional director for Africa said, “We must avoid having two different responses to monkeypox – one for Western countries which are only now experiencing significant transmission and another for Africa.” Calling for vaccine equity, she said, “We must work together and have joined-up global actions which include Africa’s experience, expertise and needs.”
Health authorities in some countries, including Canada, the UK, and the US, have begun conducting “ring vaccinations” using the smallpox vaccine, meaning close contacts of confirmed cases are being vaccinated within four days of exposure to prevent severe disease and onward transmission.
Ring vaccination interventions depend on affected communities trusting health authorities, reporting symptoms, having access to care, and the ability to participate in contact tracing, Human Rights Watch said. Public health experts have also warned against panic and stigmatizing language and called for community-led responses to the current global north outbreak.
The current outbreak has been used by some to stigmatize gay men. The WHO has said that reported cases thus far in non-endemic countries have no established travel links to an endemic area and appear to have been identified mainly among men who have sex with men. The WHO has developed guidelines for men who have sex with men, and the Centers for Disease Control and Prevention (CDC) has issued guidance on “Social Gathering, Safer Sex, and Monkeypox.”
“Whether it’s lessons drawn from HIV, Covid-19, or other public health issues, it is essential to place human rights at the center of the response to infectious disease outbreaks,” Knight said. “To curb monkeypox, the authorities should urgently make tests and vaccines available globally, and work with affected communities to erode structural barriers to accessing health information and services.”