Home Business Insights & Advice Monkeypox outbreak reveals familiar failings in global health strategy

Monkeypox outbreak reveals familiar failings in global health strategy

by John Saunders
22nd Jun 22 5:00 pm

According to recent statistics released by the UK Health Security Agency (UKHSA), the UK recorded 190 cases of monkeypox in the whole of May. Although 90 percent of confirmed cases are in London, uncertainty over the emergence of apparently unrelated infection clusters is fuelling concern over transmission throughout Europe.

As UK health authorities issue guidance to concerned citizens, researchers at Cambridge University led by Professor Jonathan Heeney are already scrambling to complete their research into a new vaccine – much like Oxford University had a leading role in pioneering the AstraZeneca COVID jab.

But while the UK appears to have responded promptly to the outbreak of monkeypox, global health bodies have been once again found wanting. These failings highlight the need to come up with a global strategy that addresses both old problems, such as the failings of early disease detection, and seeks to resolve new ones, like growing vaccine hesitancy and the dangers of anti-microbial resistance. Only in this way can the world start adequately preparing for future outbreaks and proactively respond to modern-day global health challenges.

A healthy dose of déjà vu

Back in early 2020, the UK government was caught wrong footed after the first COVID cases were confirmed in continental Europe. Although quick to rollout the COVID vaccination programme, the slow initial response was a large contributing factor towards accumulating the G7’s third-highest per-capita death rate, with 180,000 people losing their lives as a result of the pandemic. By contrast, the UK’s reaction to monkeypox has been swifter, more organised and, overall, more convincing. Within weeks of the outbreak, the government passed protocols requiring infected people to notify the local health authority and the UKHSA was already issuing regularly updated guidance.

But the international response to the spread of monkeypox has revealed all too familiar fault lines in global disease prevention and pandemic preparedness efforts. Once again, global health institutions have been slow to act, as evidenced by the fact that Nigeria had already reported around 558 cases of monkeypox since September 2017. Worse still, just as had been the case with COVID, early disease detection appears to have failed, with the head of the World Health Organization, Dr Tedros Adhanom Ghebreyesus, conceding that monkeypox may have been circulating for two full years throughout the world without being detected.

It is these systematic failures in early detection and information sharing which have prompted calls for the creation of a global pandemic preparedness strategy and disease monitoring. The UK government has been amongst the main voices in support of such measures. In the Spring of last year, Prime Minister Boris Johnson announced a plan for a so-called ‘Global Pandemic Radar’, an institution with the single objective of monitoring emerging diseases and using rapid genomic sequencing to expedite vaccine development. More recently, the Health Secretary echoed the need to create new systems and rules that encourage transparent information sharing, to avoid repeating the same mistakes as the past.

Old challenges meet new ones


But while these proposed reforms would go some way towards addressing existing shortcomings in global disease monitoring and pandemic preparedness, even more can and should be done. Both monkeypox and COVID have highlighted new challenges that must equally be addressed, such as the rise of medical misinformation and distrust in global health institutions.

A recent Ipsos survey found that people’s confidence in their governments’ ability to deal with COVID-19 is waning, while trust in global health officials and media platforms has also been eroded – three in ten adults surveyed in eight countries, including the US, France, Germany, Japan, Australia and the UK, believed that the media exaggerates the scale and scope of COVID-19.

Even more worryingly, the progressive rise in vaccine hesitancy has slowed the global vaccination campaign to a crawl. Renowned immunologist and regius professor of medicine at the University of Oxford, Sir John Bell, places much of the blame at the feet of media misinformation, which has had especially devastating consequences in Africa.

Indeed, less than 18 percent of Africans are double-vaccinated, compared to almost three-quarters of Europeans. In Africa’s most populous nation, Nigeria, just 8.1 percent of people are double vaccinated. Only four African countries – Mauritius, Morocco, Rwanda and Seychelles – have reached, or are nearing, the World Health Organization’s (WHO) 70 percent target, a figure that may already be out of reach for most African nations. In fact, demand for the vaccine in Africa is so low that the continent’s largest manufacturer of the Johnson & Johnson vaccine is facing closure.

Anticipating future health crises

There’s no simple answer to such complex issues, but governments must work together to rebuild trust in global health institutions, not least by seeking to reform them, and continuing to invest in cutting-edge medical research to anticipate tomorrow’s health crises. Although investments have recently focused on vaccine development, this is not the only priority.

Other emerging issues, such as increased antimicrobial resistance (AMR), are already posing a serious threat to global health. According to the Lancet, more than 1.2m people died as a direct result of antibiotic-resistant infections in 2019, with the highest numbers in West Africa. It’s thought that these deaths are the product of a constellation of factors including infection frequency, limited testing facilities, poor sanitation and the prevalence of counterfeit medicines. Already, the UK has taken a leading role in tackling AMR. Early this year, the government published detailed guidance, while the National Health Service has recently introduced two drugs – produced by Sanofi and Pfizer – that can kill bacteria that have become resistant to other types of medicines. At a global level, however, more needs to be done to combat AMR by preventing infections and stopping the counterfeit drug trade.

Having shown all their limitations when responding to the COVID pandemic and monkeypox, current global health protocols are in desperate need of a rethink. If the world wants to be ready to face the inevitability of future epidemics or global health crises, then leaders must agree on a global strategy that seeks to solve old and new challenges. As the arduous process of reaching such an agreement gets underway, the UK can once again show leadership by pushing its most ambitious proposals and kickstart these urgent negotiations.

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