However, that path has become more muddled by doing nothing for countries in West and Central Africa, where monkeypox was first identified decades ago and is spreading. since 2017. Vaccines are not come there; Western nations, including the US, took advantage of the limited supply. Nigeria is believed to be the source of the current international outbreak, through a long chain of transmission through several European countries before reaching the US. Unless that epidemic can be resolved, monkeypox will not be successfully controlled there or anywhere. “If the global equity issues are not addressed, if vaccines and therapeutics do not reach Nigeria and the Democratic Republic of the Congo, then that has an impact on random imports returning,” Goedel said. other places,” said Goedel.
Along this intermediate path, monkeypox continues to spread in low-income countries that cannot afford vaccines or establish infrastructure for testing. It is periodically re-entered to wealthy countries, whose populations may or may not be protected, depending on the prevalence of their vaccination programs. It remains a persistent threat to men who have sex with other men, especially in places where cultural pressures seem outspoken, or structural racism. , or simple poverty, makes it difficult to get health care sensitive to sexual identity. Sadly, the rest of the world is fine with that.
Option 3: Finish
Then there’s the worst-case scenario: We didn’t get smallpox under control in monkeys. In this imaginary future, monkeypox overcomes the imperfect containment created by an inadequate vaccine supply, leaking from the social networks of men who have sex with other men. , through other sexual partners and family members, and into the rest of society – especially those with vulnerable immune systems, including the elderly, pregnant and young em.
“The epidemiological worst-case scenario is sustained human-to-human transmission,” said Jay Varma, physician and director of the Cornell Center for Pandemic Prevention and Response at Weill Cornell Medicine in New York City. stable and effective outside of sex. “And then it will spread like chickenpox, in schools and kindergartens. And we will be facing a vaccine that has never been tested in children.”
This is the path the United States would choose if it refused to share the national stockpile of vaccines and without compromising patent exclusivity so other countries could produce them as well. Along the way, the federal government is not pressuring the Food and Drug Administration to rapidly conduct testing of the new dosing regimen and does not require gay community organizations to participate. adaptively designed clinical trials that will help to deploy the protocol faster. It also discourages drug and device manufacturers from developing inexpensive point-of-care tests that can further shorten diagnostic times.
Epidemiologist Mary Bassett, director of the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University and now the health commissioner of New York State, which declared a public health emergency before when the White House did – famous in public health circles for claiming that disease along the crevice in the community. That’s true for Covid: The disease, disability and death it causes across the country hit hardest for people of color, those in poor neighborhoods, those without political opportunity to defend yourself. The amazing fact of the monkeypox pandemic is that it can deepen those cracks even further, at the expense of those who are least able to endure it.
In the economic and political chaos imposed by Covid, the inability to organize an effective response may be inevitable. Shouldn’t run into the same problems a second time. “If there is one key lesson here,” says Frieden, “it is that — as if we needed another reminder — we are truly connected. A weak link anywhere is a threat everywhere.”
