Monkeypox makes pledges of solidarity with the epidemic seem hollow – Financial Times

The writer is a scholarly commentator

The lack of international solidarity exposed by the pandemic, especially after rich countries took advantage of Covid-19 vaccines, has led to cries of “never again”. Vital data and samples should never be retained again in the event of an outbreak; The global North should never abandon the South in its quest for money, medicine, and vaccines.

In light of the current outbreak of monkeypox, these pledges now seem hollow. High-income countries are once again scrambling for vaccines that African countries do not have access to, despite the disease in Central and West Africa for decades. Monkeypox is suspected of causing 70 deaths in Africa this year, while no deaths have been reported among the more than 4,000 cases recorded outside the continent. “The place to start any vaccine should be Africa and nowhere else,” said Ahmed Oguil, acting head of the African Centers for Disease Control and Prevention.

The ideal of global health as a public good is once again faltering in the face of national interests. The fragmented response is not just a problem in controlling monkeypox. It also points to a problem with the global pandemic treaty currently being drafted, which is designed to more tightly bind countries to work for the collective good.

An advisory panel that met at the World Health Organization last week decided not to describe monkeypox as a public health emergency of international concern. That was a “big mistake,” said Greg Gonsalves, an epidemiologist at Yale University, given that the containment process has so far failed.

Perhaps the commission felt that suddenly recognizing an epidemic in Nigeria since 2017 would send the wrong signal. However, the WHO may change course if the disease becomes more severe, spreads to different populations (currently, most cases are in men who have sex with men), or becomes present in animal populations outside Africa, further expanding the spread of the endemic virus.

The emerging science is already hinting at something unusual: preliminary research published last week indicates that the virus is present Develop faster than expected. And the outbreak, which has infected 48 countries so far, has not gone away. The UK alone has recorded more than 900 cases as of June 27. Spain and Germany are also seeing high numbers of cases. At the pandemic preparedness conference I attended in Brussels last week, few scientists were willing to rule out a monkeypox pandemic.

The main theme of the conference, which focused on respiratory viruses, was to ensure that mistakes of Covid-19, such as delays in case reporting and poor messaging, were not repeated. One proposed treatment is the World Health Organization’s Treaty on Epidemic Preparedness, sometimes called the Global Pandemic Treaty. The treaty will legally oblige the signatories to practices such as exchanging data in a timely manner. The Initial Draft will be released in August. The treaty is already the subject of false claims that it will strip states of sovereignty and impose imprisonment on non-vaccinators. The real obstacles are more real: since the WHO is a technical agency rather than a legal agency, can it implement treaty obligations?

But for Mark Eccleston Turner, an expert in global health law at King’s College London, the treaty could fail because it is a “neo-colonial” instrument designed to crystallize, rather than erase, power imbalances between nations. He says early releases appear to force low- and middle-income countries to immediately share samples and data, giving other countries time to close borders and stockpile medicines, vaccines, and protective gear — but without establishing equitable access to those drugs and vaccines in return.

Ecclestone Turner told me that “the fundamental problem with our system, and the problem that the treaty currently entrenches, is that the samples, data, and information for low- and middle-income countries [low- and middle-income countries] They are public goods and must be shared for the benefit of humanity, while vaccines and other medical countermeasures are private goods that must be stored and accessed by the world’s richest people first.”

The monkeypox vaccinations now only hastily reinforce his view.

Treaties are legal tools designed to bind and protect all parties. But treatment should not leave the patient worse off. Without careful scripting, the pandemic treaty risks protecting high-income countries without obligating them, and obligating low- and middle-income countries without protecting them.

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