The World Health Organization recently declared monkeypox – a disease that has been a concern in African countries for years – a global public health emergency.
Monkeypox has been spreading globally in recent months, with 75 countries reporting cases.
Although the WHO has declared its highest level of alert, this does not mean that monkeypox is highly contagious or necessarily deadly, says Kerry Bowmanassistant professor in the Department of Family and Community Medicine in the Temerty School of Medicine and the School of the Environment in the School of Arts and Sciences.
“It doesn’t mean we’re facing a situation like COVID-19,” Bowman says. “[But] I think it’s a good decision. It has been in Africa for some time and is now appearing in new parts of the world.
A collaborative research effort by the university and partner hospitals – including the University Health Network, Sunnybrook Research Institute and Unity Health Toronto – is underway to investigate the global monkeypox epidemic. The team’s findings will help inform the public health response to the outbreak in Canada and support efforts in other countries where the virus is endemic.
U of T News recently spoke with Bowman about the WHO’s designation of monkeypox as a global health emergency, how this may change the international response to the outbreak, and what can be done to address the rise of zoonotic diseases in general.
What does the name WHO mean?
This means that we have an alarming disease that is spreading worldwide. There’s no arguing about that. This does not necessarily mean that it is highly contagious or that it is very deadly. You may recall that the WHO did this about Zika, which may not have had consequences for many of us.
So this does not mean that we are facing another situation like COVID-19. The WHO was quite divided on whether it was necessary to trigger the highest level of alert. But I think it’s a good decision. It has been in Africa for some time and is now appearing in new parts of the world.
How might the global response to monkeypox change with this new designation?
What it could mean in the future is travel warnings and restrictions. People coming from countries with a high prevalence of monkeypox, which is currently the United States and parts of the European Union, may go through higher screening at airports. If a person is unwell and officials suspect it is monkeypox, they can order quarantine or detention. I emphasize the word “may” in this scenario.
I hope this will encourage countries like Canada to start fighting monkeypox before it really takes root – to get ahead of it in terms of vaccinating and offering vaccinations. From a public health perspective, it is important to ensure that this can be contained before it becomes something that is endemic here.
What more can be done to reduce the risk of transmission?
Vaccine access and education are huge. At this stage it should be readily available and people should decide for themselves whether they want it or not.
The other concern I have is that until recently our leaders have been vague about how many vaccines we have, what our vaccine situation is, and what our plans are with it. Democracy and public health should never be opaque. You really need to let the public know what we’re dealing with.
It is currently unclear what our vaccine supplies are and whether we have enough for the long term. It’s still a very slow, inconsistent process to get vaccinated.
One element that I think we are overlooking on a global level is: where do all these terrible diseases come from? Monkeypox undoubtedly has an environmental and climate change component. It is not the only factor, but it is clearly a contributing factor. We continue to not look at the upstream causes of zoonotic diseases – diseases that come from animals, just like this one did.
Can you expand on that?
There is a link between climate change and biodiversity loss that we are simply ignoring.
What’s happening is that with more and more deforestation and climate change in Africa and other tropical regions, you have more non-human species moving around and being hunted. Interaction between animals and humans is increasing as there is both environmental degradation and habitat loss. We are opening up more tracts of what was once virgin forest and exposing people to these viruses.
The number of zoonotic diseases that are increasing is significant.
How can we deal with this?
In the early days of the COVID-19 pandemic, we had some awareness of this – but almost nothing is being done to prevent more of these diseases from occurring.
A real flaw in Western medicine is that we have these protective walls where we don’t pass in anything from the environment. This is the way we have organized ourselves – to our detriment.
We need much more of a “One Health” approach. One Health and planetary health is something that looks at how all these systems work together – human, non-human and biodiversity.
In national and global planning, we must consider the consequences of mass deforestation in equatorial regions. We must also look at the health and well-being of Canada’s ecosystems and animal health.
For human health to flourish, we must look through the lens of environmental parameters.
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