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WHO to decide if Monkeypox constitutes international emergency

World Health Organisation officials will decide this week whether monkeypox constitutes an international public health emergency.

The organisation claims that Europe remains the ‘epicentre’ of the ‘outbreak’ with 1,500 cases.

The WHO argues for a three pronged approach, consisting of surveillance, ‘swift information-sharing mechanisms’ and an ad campaign targeting summer outdoor events including Pride events, and isolation and infection control measures such as contact tracing.

“Governments, health partners and civil society need to act with urgency, and together to control this outbreak; and there are three basic steps needed,” WHO Regional Director for Europe, Dr Hans Kluge said.

Monkeypox patients – both suspected and confirmed – will face 21 days of isolation with what the WHO describes as ‘the necessary control measures’ while ‘self-monitoring’ for early symptoms, such as fever.

Close contacts will also be required to isolate for 21 days.

Mr Kluge points out that the majority of cases to date have occurred among gay men, with many reporting anonymous sexual partners, making contract tracing more challenging.

“So far in Europe, the majority – though not all – of reported patients, have been among men who have sex with men. Many – but not all patients – report multiple and sometimes anonymous sexual partners. Identifying, tracing and notifying sexual partners quickly is therefore often difficult, but remains critical in order to stop onwards spread,” he said.

In order to avert stigma, Mr Kluge said it is important to remember ‘the monkeypox virus is not in itself attached to any specific group.’

“Stigmatizing certain populations undermines the public health response as we have seen time and again in contexts as diverse as HIV/AIDS, tuberculosis and COVID-19,” he said.

The organisation recommends ‘intensive community engagement’ in order to drive its monkeypox message, with plans to target summer tourism, various Pride events, music festivals alongside dating apps.

“These events are powerful opportunities to engage with young, sexually active and highly mobile people. Monkeypox is not a reason to cancel events, but an opportunity to leverage them to drive our engagement,” Mr Kluge said.

The third step is what the WHO describes as ‘genuine and unselfish regional collaboration’ despite the fact that monkeypox has been endemic in parts of Africa for decades.

Since 2017, Nigeria has reported what the WHO describes as ‘a large outbreak,’ of 200 confirmed cases, with a 3% fatality rate. Nigeria is the most populated country in Africa, with a population of more than 216 million people.

Elsewhere in WHO monkeypox literature, the virus is described as less contagious than smallpox and causing less severe illness. Symptoms include fever, rash and swollen lymph nodes.

“For decades, monkeypox has been endemic in parts of western and central Africa – and for decades it has been neglected by the rest of the world. Now that it is in Europe and elsewhere, we have seen yet again how a challenge in one part of the world can so easily and quickly be a challenge for all of us – and how we must all work together to ensure a coordinated response that is fair to one and all, especially the most vulnerable.”

Mr Kluge then points out that there are ‘currently limited amounts of vaccines and antivirals for monkeypox, and limited data on their use’ while warning against the ‘me first’ approach that saw by western countries scrambling to stockpile Covid 19 vaccines.

“I beseech governments to tackle monkeypox without repeating the mistakes of the pandemic – and keeping equity at the heart of all we do,” Mr Kluge said before closing his statement by calling for united action for better health in Europe.

“Indeed, united action for better health in Europe has never been as critical as today.”

Meanwhile, over in Indonesia at the G20 Health Minister’s Meeting today (June 20), attendees were informed of a new ‘proposal for a new global architecture for health emergency preparedness and response.’

WHO Director General Dr Tedros Ghebreyesus told the meeting that at this new global proposal was tabled at the World Health Assembly last month.

The proposal includes ten recommendations for stronger governance, stronger financing and a stronger WHO ‘at the centre of the global health security architecture.’

A key recommendation is the creation of a Financial Intermediary Fund (FIF), housed at the World Bank.

“WHO and the World Bank estimate that 31 billion US dollars is needed every year for strengthening global health security. Two-thirds of that could come from existing resources, but that leaves a gap of 10 billion US dollars per year. A flexible and agile FIF would help to close that gap,” Dr Tedros said.

The director general said the WHO has been working closely with the World Bank on what the FIF would look like while listening to G20 countries in the process.

“Our proposal is that the FIF would be overseen by a board that makes decisions about funding allocations, supported by a technical advisory panel.

“The Bank would provide financial and administrative leadership in the Secretariat, operating as trustee for the FIF, holding and transferring donor funds, and providing administrative services,” the WHO director general said.

The WHO would provide technical leadership such as recommendations and reports to the joint World Bank-WHO secretariat, based at the Bank’s headquarters in Washington

The World Bank and WHO would act as ‘implementing entities,’ according to Dr Tedros, alongside organisations including the Global Fund, Gavi , FIND,  CEPI and others.

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