WHO to determine whether Monkeypox should be declared an ‘Emergency of International Concern’; rights expert warns of COVID ‘vaccine apartheid’

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The experts will meet on June 23 to assess whether the ongoing outbreak is a public health emergency of international concern, the highest level of global warning, which currently only applies to the COVID-19 pandemic and polio.

So far this year, more than 1,600 confirmed cases and nearly 1,500 suspected cases of monkeypox have been reported to the WHO, in 39 countries – including seven countries where monkeypox has been discovered for years, and 32 newly affected countries.

At least 72 deaths have been reported from previously affected countries† No deaths have been recorded so far from the newly affected countries, but the agency is trying to verify news reports of a related death in Brazil.

Monkeypox’s Global Outbreak Is Clearly Unusual and Concernsaid WHO director Tedros Adhanom Gebreyesus, calling for increased response and international coordination.

Ibrahima Socé Fall, WHO’s deputy director for emergency response, explained that the risk of spreading is considered “high” in Europe, while in the rest of the world it is “moderate” and there are still knowledge gaps about how it works. virus is transmitted.

We don’t want to wait for the situation to get out of hand“, he said.

Case detection and control

The WHO has published recommendations for governments regarding case detection and monitoring.

Speaking to journalists in Geneva, WHO smallpox expert Rosamund Lewis said it was crucial to raise public awareness about the level of risk and explain the recommendations to avoid infecting close contacts and family members.

dr. Lewis explained that while the disease sometimes causes only mild symptoms, such as skin lesions, it can be contagious for two to four weeks.

“We know that it is very difficult for people to isolate themselves for so long, but it is very important to protect others. In most cases, people can self-isolate at home and do not need to be in the hospital,” she added.

Monkeypox is transmitted through close physical contact with someone who has symptoms. The rash, fluid and scabs are especially contagious. Also clothing, bedding, towels or objects such as eating utensils or plates that are contaminated with the virus can infect others.

However, it is not clear whether people who have no symptoms can spread the disease, the expert reiterated.

© CDC

An enlarged image of a piece of skin tissue harvested from a lesion on the skin of a monkey infected with the monkeypox virus.

Vaccination Guidelines

The WHO also published new guidelines on vaccination against Monkeypox on Tuesday.

While some countries have kept strategic stocks of older smallpox vaccines – a virus eradicated in 1980 – these first-generation vaccines kept in national stocks are not currently recommended for Monkeypox, as they do not meet current safety and manufacturing standards. .

There are also newer and safer (second and third generation) smallpox vaccines available, some of which may be helpful for Monkeypox and one (MVA-BN) is approved for the prevention of the disease

The supply of these new vaccines is limited, and entry strategies are under discussion, the WHO said.

“Right now, the World Health Organization does not recommend mass vaccination† In any case, decisions on whether to use smallpox or Monkeypox vaccines should be based on a full assessment of the risks and benefits,” the guidelines state.

For the contacts of sick patients, post-exposure prophylaxis with a second or third generation vaccine is recommended, ideally within four days of the first exposure to prevent the onset of disease.

Pre-exposure prophylaxis is recommended for health professionals at risk, laboratory personnel working with orthopox viruses, clinical laboratory personnel performing diagnostic tests for Monkeypox, and others who may be at risk.

Monkeypox is a rare but dangerous infection similar to the now eradicated smallpox virus.

© CDC/Cynthia S. Goldsmith

Monkeypox is a rare but dangerous infection similar to the now eradicated smallpox virus.

Studies outdated

dr. Lewis explained that most of the data on the smallpox vaccine is old or from animal studies. “There are not many [current] clinical studies,” she said.

The WHO underlined the importance of vaccination programs supported by extensive surveillance and contact tracing, accompanied by information campaigns and robust “pharmacovigilance”, ideally with collaborative studies of vaccine efficacy.

Tedros also said the agency was working with partners to rename Monkeypox and its variants, as well as establish a mechanism to share available vaccines more fairly, if needed.

Continued decline in COVID-19 cases

Regarding the current situation with the COVID-19 pandemic, Tedros said both reported cases and deaths have declined by more than 90 percent, compared to highs reached earlier this year.

“This is a very welcome trend. Yet more than 3 million cases were reported to the WHO last week – and because many countries have reduced surveillance and testing, we know this number is under-reported,” he added.

During that time, 8,737 deaths were reported. Tedros called this an “unacceptable level” when they are effective tools to prevent, detect and treat this disease.

The WHO chief also called on countries to reach an agreement on the temporary intellectual property rights exemption for COVID-19 vaccines, treatments and diagnostic tests at this week’s World Trade Organization ministerial conference.

“As I’ve said many times, the waiver was created for emergency use. So, if not now, when?” he said.

An employee works on the production line of a COVID-19 vaccine in India

© UNICEF/ Dhiraj Singh

An employee works on the production line of a COVID-19 vaccine in India

Alarm ‘Vaccine apartheid’

This request was echoed by the Special Rapporteur on Contemporary Forms of Racism, E. Tendayi Achiume, who called the growing inequalities in access to vaccinations a form of “vaccine apartheid”.

“Since the people most harmed by vaccine apartheid are racially marginalized peoples, unequal access to COVID-19 vaccines and treatments within and between countries is unmistakably a matter of racial injustice,” she said.

“This injustice is exacerbated by persistent inequalities of wealth, power and health resources between states, which can be traced back to transnational histories of racism and colonialism,” she added.

Until this month, 72.09% of people in high-income countries had been vaccinated with at least one dose of the COVID-19 vaccine, she noted, compared with just 17.94% of people in low-income countries. income: “The current status quo amounts to a system of ‘vaccine apartheid’.

In her letter to members of the World Trade Organization, the independent expert urged state representatives at this week’s ministerial conference to follow the commitments and legal obligations for equality and non-discrimination enshrined in international human rights law. to come.

“States must demonstrate the political will, leadership and determined commitment to racial equality that transformative change requires,” said Ms Achiume.



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