Alison Barrett writes:
Australia should implement a coordinated response to stop the transmission of monkeypox and protect priority populations in response to the recent declaration of monkeypox by the World Health Organization as a public health emergency of concern international (PHEIC).
The WHO statement also means that countries such as Australia should step up public health measures, such as supports for isolating infected people, contact tracing, vaccination and targeted use of pre-exposure prophylaxis vaccines in exposed populations high exposure
Likewise, countries such as Australia that have reported cases of monkeypox in the past 21 days should strengthen clinical management and infection prevention and control in healthcare settings and accelerate research into the use of vaccines, therapeutics and other tools, according to the statement.
Croakey was unable to find a statement from the Australian Government Department of Health website regarding WHO’s determination of monkeypox as a PHEIC. We asked the DOH for a comment, but no response has been received as of July 27.
Public health emergency
WHO declared monkeypox a PHEIC after a second meeting of the International Health Regulations (2005) Emergency Committee on the outbreak on 23 July.
According to the WHO, the Committee could not reach a consensus on its advice to declare monkeypox as a PHEIC; WHO Director-General Tedros Adhanom Ghebreyesus made the final decision.
According to the IHR, a public health emergency of international concern is
an extraordinary event, which constitutes a public health risk to other states through international diffusion, and which potentially requires a coordinated international response”.
Panel members’ views in support of a PHEIC determination included:
- That the monkeypox outbreak meets all three PHEIC criteria
- Upward trends in global cases and countries where monkeypox is reported
- Cases reported in children and pregnant women
- Support and resources needed for the LGBTIQA+ community, which is the most affected community outside of Africa
- The modes of transmission of the current outbreak are not fully understood
- Perceived benefits of declaring it a PHEIC include maintaining awareness, driving coordinated international commitments and political response.
The views of Committee members who do not support PHEIC:
- The overall risk assessment has not changed since June 23, 2022
- Based on the available data, there is no indication of an exponential increase in the number of cases
- Most cases are seen among men who have sex with men with multiple partners and there was a perception that there is still opportunity to stop ongoing transmission with targeted interventions in this group.
- Perception of low severity of the disease.
Ghebreyesus said:
Although I am declaring a public health emergency of international concern, for now this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners.
This means that this is an outbreak that can be stopped with the right strategies for the right groups.
It is therefore essential that all countries work closely with communities of men who have sex with men to design and deliver effective information and services, and to adopt measures that protect the health, human rights and dignity of women. affected communities.
Stigma and discrimination can be as dangerous as any virus.”
Global health expert Professor Kathryn H. Jacobsen wrote in The Conversation that the declaration was not cause for panic, but “is a way to prevent monkey pox from becoming a global crisis.”
Recommendations
WHO also issued interim recommendations for countries’ response to the monkeypox outbreak at the IHR meeting.
Depending on the epidemiological situation, transmission patterns and capacities, different recommendations apply in different countries.
“All interim recommendations are expected to be implemented with full respect for established principles of human rights, inclusion and dignity of all people and communities,” WHO says.
Below are recommendations for four groups of countries identified:
1. Those who have no history of monkeypox in human populations or have not detected a case for more than 21 days.
The main recommendation is to strengthen “all aspects of preparedness to respond to monkeypox and stop human-to-human transmission,” including disease surveillance and identification, testing, awareness and risk communication among current groups high risk
2. Those with newly imported cases of monkeypox into the human population and are experiencing person-to-person transmission.
The main recommendations are to “implement a coordinated response to stop transmission” and protect priority populations.
Step up public health measures, such as isolation supports for infected people, contact tracing, vaccination and targeted use of pre-exposure prophylaxis vaccines in high-exposure populations (such as healthcare workers)
Strengthen clinical management and infection prevention and control in healthcare settings and accelerate research into the use of vaccines, therapeutics and other tools.
3. Those with transmission of monkey pox between animals and humans.
Detailed case studies of transmission between animals and humans are recommended to gain a better understanding of transmission patterns.
4. Countries with manufacturing capacity for vaccines, diagnostics and therapeutics should increase production and work with WHO to ensure they are distributed “at reasonable cost to countries where they are most needed to support efforts to stop the spread of monkey pox”.
Full recommendations can be found in this statement.
Concerns were raised at the meeting about the price and distribution of vaccines and antivirals and the need to ensure they are equitably available.
As the tweets below suggest, the decision raises questions and concerns about the potential for discrimination, stigma and human rights abuses.
Australia’s answer
As Australia has reported cases of monkeypox in the past 21 days, this would put us in Group Two of recommendations, with the need to step up public health measures and implement a coordinated response to stop transmission.
Associate Professor Michael Burke, a GP in western Sydney, told newsGP that “GPs have a very key role to play, they need to be aware of the symptoms, then do the right tests and make sure that people do the necessary isolation.” said
Last week, Croakey reported that the federal government has been urged to vaccinate at-risk groups and that containment of the virus “would be best achieved with antiviral treatments and third-generation smallpox vaccines”.
The designation of monkeypox as a PHEIC, along with COVID-19 and polio, and future emerging infectious diseases has been linked to plans for an Australian Center for Disease Prevention and Control, as as Australian Public Health Association president Dr Tarun Weeramanthri tweeted. He called for national communications to inform the public about the importance of the WHO statement.
More from Twitter
Follow this list of monkey pox sources.
Please see Croakey’s archive of monkey pox articles.