The Covid-19 outbreak forced governments around the world to make changes to their response programs. The upgrades are falling short now that they are being tested.
Getting out in front of the global flare-up of the monkeypox virus is doable, according to infectious disease experts. The World Health Organization sounded the alarm because of the lack of coordination in testing and treatment.
The director-general of the World Health Organization declared the outbreak a public health emergency on Saturday. Tedros acted despite a majority of experts suggesting it wasn't needed.
Tedros said that the outbreak is concentrated among men who have sex with men and among those who have multiple partners.
Tedros said that we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we don't know enough.
There is a disease that has been around for a long time. It was first reported in humans in West Africa in 1970. There was a 2003 outbreak in the US that was linked to imported rodents.
The current version can be spread through direct contact with a person's body fluids. Monkeypox can change how it affects people if the virus continues to circulate. According to early research, the current version has accumulated almost 50 changes in the last few years.
There are reports of cases in children. Children and people with weakened immune systems are at greater risk of contracting monkeypox.
Speed is important in infectious-disease outbreaks. The longer monkeypox spreads around the world, the more likely it is to become an endemic disease. Public health experts are racing to contain the infection rate of the monkeypox pathogen before it circulates widely in human populations. The global response has been different.
Lawrence Gostin is the director of the WHO's Center on Global Health Law and a public health professor at the University of Baltimore.
It is difficult to understand the full picture of the monkeypox outbreak because of limited testing, insufficient vaccine doses, inadequate access to antiviral treatments and data gaps.
Governments in countries without cases are being urged by the WHO to step up vigilance. The health agency recommends that governments create response plans with the goal of stopping human-to-human transmission in countries where the virus has already been detected.
The professor at the London School of Hygiene and Tropical Medicine hopes that the increased attention to this disease will lead to more focus on control within Africa, where the number of cases has been increasing for the past 20 years.
It has been a problem to test for monkeypox. Because of a lack of testing or mis-diagnosis, the true number of cases is higher than has been estimated. Mike Ryan, WHO emergencies program director, said at a media briefing that the last few decades have been a poor time for monkeypox research.
The drunk man looking for his keys under the lamp post is what we are seeing at the moment. We're not looking in the dark.
A lack of resources at sexual health clinics, the frontline of the current outbreak, has been another weakness in the current international response.
When there are multiple competing priorities for governmental attention and funds, it's important that this outbreak can be prioritized. The World Health Organization believes that the outbreak is controllable with public health measures, but that the window of opportunity is closing fast.
One day after US health officials said they were weighing a similar move which could free up funding to support a robust public health response, the White House released research priorities aimed at improving the government's knowledge of the virus and how to prevent.
The US outbreak, which has spread to more than 2,800 people, has raised concerns, including from Republican Senator Richard Burr, a fierce critic of the nation's Covid-19 response.
When the monkeypox outbreak began in May, US health officials sought to assure the public that the country was prepared based on decades of research.
It became obvious that wasn't enough. Problems that persisted throughout the Covid Pandemic were underscored by insufficient testing and a shaky vaccine launch. The CDC is struggling to get states to share demographic information about monkeypox cases despite the fact that this information is reported for Covid. There is no information on who has been vaccined against monkeypox.
If we have allowed monkeypox to become an endemic virus in the U.S. — which is becoming an increasingly possible outcome — it will be among the most unfortunate public health failures in recent times.
— Scott Gottlieb, MD (@ScottGottliebMD) July 24, 2022
Issues have arisen recently. A regulatory process that requires dozens of pages of paperwork has made it difficult for clinicians to give antivirals to patients. While other countries have begun clinical trials for Tpoxx, the US is not currently doing the same.
The US health officials have said that they are working round-the-clock to fix problems that have emerged, and that they will deploy $140 million to support research to improve modeling, forecasting and surveillance. Most of the vaccine will not be available until later this year.
The scientists at the White House are looking into ways to stretch the vaccine supply. Anthony Fauci, chief medical adviser to President Joe Biden, said on MSNBC that the US should have more vaccine by the end of the month. The CDC made it easier for clinicians to prescribe Tpoxx on Friday after the HHS made it easier to test for it.
Andrew Hebbeler, who leads the health and life sciences efforts in the White House Office of Science and Technology Policy, said that there is real human suffering right now. We need to accelerate not only the generation of data that will plug the gaps in our knowledge but also the application of that knowledge.
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