For the past month, a couple of patients have sat across from the doctor at the H.I.V. clinic to hear if they have monkeypox. The men are affected by the disease. They are afraid because they are seen as men who have sex with men, a dangerous identity in a country where there is intense discrimination against homosexuality.
He has little to offer. He told an interviewer that he had no options. The vaccine used against monkeypox in the US and Europe is not available in Peru.
Even though we are the country with the highest number of cases, we don't have anything.
According to the World Health Organization, Brazil has close to 10 percent of the world's monkeypox cases. No, the countries in West and Central Africa that have been affected by monkeypox have not.
The United States and Europe have been the center of the scramble for vaccine and treatments. Most of the countries that have reported monkeypox have had no vaccine or treatments at all.
Wealthy nations bought up most of the available doses to keep them out of sight. After the terrorist attacks of Sept. 11, 2001, the United States gained control of most of the vaccine. The W.H.O. was criticized for not doing more to ensure swift movement on equitable access to tests, treatments and vaccines after it declared monkeypox a public health emergency. The issues are similar to those seen with Covid, but without any of the mechanisms that were developed to try to correct the balance during the coronaviruses epidemic.
It's hard to know the number of people who have monkeypox in developing nations because many don't have the capacity to perform a P.C.R. test. The majority of the testing in countries that have had an outbreak for a long time is done at the level of epidemiology. Many of the patients who live in isolated rural areas don't have access to testing.
We don't have access to testing in Africa, so we can't use that as a basis for decisions on the use of resources
The majority of people who die from monkeypox are from Africa. There are two different strains of the disease, one of which is more lethal than the other and is being seen in high income countries. Children and pregnant women are at greater risk of dying from monkeypox than anyone else.
Monkeypox is what it is. The symptoms of monkeypox are not as severe as those ofpox. There was an outbreak in monkeys kept for research. Most of the people who have sex with men who have the virus are from Central and West Africa.
What does it do? The monkeypox virus can be spread by coughing or sneezing, or by touching items that have previously touched the rash, or by touching items that have not touched the rash. During and after birth, monkeypox can be transmitted from the mother to the fetus.
I'm afraid I might have a disease. I don't know what to do. You can't test for monkeypox if you only have flu symptoms. You can get a monkeypox test from an urgent care center or your primary care doctor. If you have to come in contact with other people for medical care, you should be isolated at home.
I live in the city. Is it possible to get the vaccine? Adult men who have sex with men and have had multiple sexual partners in the last 14 days are eligible for a vaccine in New York City. People with conditions that weaken the immune system or have a history of allergies are encouraged to get the vaccine. There is a website that people can use to book an appointment.
A scramble for vaccines was set off by the rapid spread of the disease to high income nations. There is no vaccine for monkeypox, but data from trials with nonhuman primate suggested that a vaccine against the smallpox virus could prevent transmission. The Jynneos vaccine was the focus because it is the easiest to administer and has the lowest number of side effects.
The United States contributed more than $1 billion to the development of the vaccine as a defense strategy after 9/11 because officials feared small pox could be used as a bio weapon. Distribution of the U.S. doses was slowed because they were earmarked as a defense stockpile and bulk drug. Canada, Australia and European countries bought 1 million of the remaining 1 million.
There is no purchase or order for African countries at this time. There is no vaccine supply for health workers in the country where a clinical trial of the Jynneos vaccine is taking place.
The solution for this problem is for the U.S. government to put all of the doses it owns into vials, so they can go into arms in the U.S. The most important step anyone can take to bring this outbreak under control is this.
The 7 million doses sent so far are not designated for global access.
The Jynneos vaccine is being paid for by high-income countries, according to an analysis by Public Citizen. The vaccine would be discounted only for high-volume buyers, according to the president of the company.
It's too expensive for a country likePeru.
Brazil's ministry of health confirmed that it expected to receive 50,000 of the small number of doses donated by the W.H.O.
Public health groups think the W.H.O.'s efforts are not helpful.
There is a lack of clear guidance from the W.H.O. on a strategy for getting vaccines, treatments and tests to countries that need them. It doesn't make sense to declare an emergency without giving any information about the tools to respond.
The global response to monkeypox was complicated by the fact that most of the medical interventions lacked human clinical trial data.
She said that people think that it will be a matter of days, but that is not the case. The goal is to shorten the time between each step to make it happen quicker. It is not so simple. Something needs to be safe and effective.
In humans and nonhuman primate, the efficacy of the drug Tpoxx has been tested. Data from the first of two human trials to test against monkeypox should be reported early next year. The W.H.O. can't do the typical prequalification process because of the lack of humans.
The original sin is that we could have tested these things in endemic countries. He said there wasn't much appetite or investment in monkeypox when it was limited to only two countries.
The absence of vaccines could potentially help to slow the spread of the virus by reducing symptoms and making patients less infectious. According to Dr. Briand of the W.H.O., it was easier to manufacture, test and distribute diagnostics and treatments than it was to get a vaccine. The initial response would focus on these and other behavior change interventions.
Costs could be an issue as well. Siga Technologies, a New York company, has been making batches of it for years and selling them to the U.S. government for national security reserves. In April, Canada signed a contract to purchase the drug for $920 per course, but the company wouldn't reveal pricing information.
Siga wants this drug to have broad access.
Dr. Gomez said that Siga could produce 500,000 courses per year and that it had product available to ship from its warehouses. He said that the company would be willing to expand production with more contract manufacturers in the U.S.
There is a need for a rapid diagnostic test that can be used in low-income countries. It's possible to break off transmission early.
The global monkeypox response has been complicated by the role of smallpox as a bio weapons threat. There are limits on transparency with data about vaccine and treatment inventories, which are considered national security issues, and access to the biomedical interventions is controlled by defense experts.
The lines of command and the decision-making processes that were established for that were different than the ones we are currently seeing
The national security decision makers who control access to the vaccine stockpile seem to think that nobody is dying so it is not a security threat.
Many public health experts say that a lethargic monkeypox response ignores the risks posed by this virus that is behaving in ways not seen before.
Dr. Titanji said that Monkeypox has a large runway to better adapt. Not getting on top of another pox virus is a bad thing.
The reporting from Rio de Brazil was done by the person who gave it.
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