The World Health Organisation (WHO) has started a discussion on monkeypox at its 75th World Health Assembly (WHA) that began in Geneva on 22nd May. A key agenda of the WHA is a 'pandemic accord' in which member countries will vote on proposed amendments to the International Health Regulations (IHRs). Only 30-odd cases of monkeypox have been reported in 14 countries. Yet, WHO warns that the infection could spread to more countries just as international travel is getting back to normal after two years of COVID-related disruption.
Although no case of monkeypox has been reported in India, the Indian government is on alert and the Integrated Disease Surveillance Programme (IDSP) has issued an interim advisory based on cases reported in other countries. The good news is that there were no deaths reported until 20 May 2022. The WHO has said that at least 92 monkeypox virus cases have been confirmed in 14 countries, including the US, Canada, Australia, UK, Spain, Portugal, Germany, Belgium, France, the Netherlands, Italy, Sweden and, more recently, Israel and Switzerland.
What Is Monkeypox
The IDSP describes it as a viral zoonotic disease usually occurring in central and west Africa. It is a self-limited disease that lasts two to four weeks and patients suffer from fever, rash in the form of blisters or pustules and swollen lymph nodes. The rash spreads from the head to the rest of the body and resembles smallpox.
The virus can be transmitted from animals to humans and from person to person with the virus entering the body through broken skin, respiratory tract or the mucous membranes (eyes, nose and mouth) or be transmitted through body fluid. Monkeypox resembles smallpox, but is less contagious; however, an affected person could transmit it until all scabs fall off. It can also be transmitted through direct contact with body fluids or lesion material, and indirect contact with lesion material, such as through contaminated clothing or linens of an infected person.
The rash usually spreads from the head to the rest of the body. Palms of hands and soles of feet may also be affected.
The US Food and Drug Administration (FDA) approved a smallpox drug to treat monkeypox patients, while the WHO revealed it will hold daily meetings as the situation unfolds.
Controversy of Smallpox Stockpiling
Monkeypox can be effectively stopped with smallpox vaccines, so a huge controversy has erupted over US companies apparently having anticipated such an outbreak and their stockpiling of smallpox vaccines, long after smallpox was successfully eradicated around the world.
As with COVID-19 and its mutations, there is talk about bio-engineering and weaponising disease to create panic and promote the sale of vaccines. The WHA’s push for a pandemic accord is also interesting in this context. It will prescribe measures expressly provided for and the regulations include lock-downs, hard borders around quarantine zones, vaccine passports, mandatory check-in and contact tracing, mandatory health tests, mandatory removal and quarantine. Compulsory vaccination is part of the IHRs. These regulations would be in place for as long as WHO decides it is necessary.
In effect, there is the expectation that the world has to be prepared for regular pandemics and one of the solutions offered is a variety of vaccines prescribed and mandated by countries that sign the accord. Since the WHO is responsible for declaring public health emergency of international concern (PHEIC) and pandemic, the pandemic accord will significantly expand the global health agency's power to intervene in a country in the event of a future pandemic outbreak or health emergency.
Some critics and medical professionals have alleged that the hype in the current monkeypox outbreak in the European Union (EU) and US is to ignite debate favouring the pandemic treaty during the WHA, given that monkeypox is not believed to be as transmissible as other common viruses.
There are also concerns over media reports. The US ordered 13mn (million) additional doses of the monkeypox vaccine after a Massachusetts man contracted the rare but potentially severe virus. In a report, Newsweek says
, the massive US$119mn order of Jynneos jabs—which can be used to treat both the monkeypox virus and smallpox—was created by the biotechnology company Bavarian Nordic.
Under its agreement with Bavarian Nordic, the US Biomedical Advanced Research and Development Authority can still exercise options worth US$180mn for about 13mn freeze-dried doses of the smallpox vaccine in the future, says a report from the Washington Post
WHO's Top Funders
According to the global health agency's financial report, BMGF and Gavi, the vaccine alliance, remain its top contributors. Nearly 10% of WHO's funds come from philanthropic foundations, predominantly the Bill & Melinda Gates Foundation.
(Source: WHO Financing and implementation of the Programme budget 2022–2023 www.apps.who.int/gb/ebwha/pdf_files/WHA75/A75_27-en.pdf )