Sunday, June 26, 2022

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WHO panel: Monkeypox not a global emergency 'at this stage'

Posted: 25 Jun 2022 06:44 PM PDT

THE World Health Organization (WHO) said the escalating monkeypox outbreak in more than 50 countries should be closely monitored but does not warrant being declared a global health emergency.In a statement Saturday, a WHO emergency committee said many aspects of the outbreak were "unusual" and acknowledged that monkeypox — which is endemic in some African countries — has been neglected for years."While a few members expressed differing views, the committee resolved by consensus to advise the WHO director-general that at this stage the outbreak should be determined to not constitute" a global health emergency, WHO said in a statement.WHO nevertheless pointed to the "emergency nature" of the outbreak and said controlling its spread requires an "intense" response.The committee said the outbreak should be "closely monitored and reviewed after a few weeks." But it would recommend a re-assessment before then if certain new developments emerge — such as cases among sex workers; spread to other countries or within countries that have already had cases; increased severity of cases; or an increasing rate of spread.WHO Director-General Tedros Adhanom Ghebreysus convened the emergency committee on Thursday after expressing concern about the epidemic of monkeypox in countries that haven't previously reported the disease."What makes the current outbreak especially concerning is the rapid, continuing spread into new countries and regions and the risk of further, sustained transmission into vulnerable populations including people that are immunocompromised, pregnant women and children," the WHO chief said.Monkeypox has sickened people for decades in central and west Africa, but until last month, the disease had not been known to cause significant outbreaks in multiple countries at the same time and involving people with no travel links to the continent.Declaring a global health emergency means that a health crisis is an "extraordinary" event requiring a globally-managed response and that a disease is at high risk of spilling across borders. WHO previously made similar declarations for diseases including COVID-19, Ebola in Congo and West Africa, Zika in Brazil and the ongoing effort to wipe out polio.The emergency declaration mostly serves as a plea to draw more global resources and attention to an outbreak. Past announcements have had mixed impact, given that WHO is largely powerless when trying to convince countries to act.WHO said this week it has confirmed more than 3,200 monkeypox infections in about 40 countries that haven't previously reported the disease. The vast majority of cases are in men who are gay, bisexual or have sex with other men and more than 80% of the cases are in Europe.A leading WHO adviser said last month the spike in cases in Europe was likely tied to sexual activity by men at two raves in Spain and Belgium, speculating that its appearance in the gay and bisexual community was a "random event." British officials have said most cases in the U.K. involve men who reported having sex with other men in venues such as saunas and sex clubs.Scientists warn that anyone in close, physical contact with someone infected with monkeypox or their clothing or bedsheets is at risk of catching the disease, regardless of their sexual orientation.People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without needing medical care.Monkeypox in Africa mostly affects people who come into contact with infected wild animals, like rodents or primates. There has been about 1,500 reported cases of monkeypox, including 70 deaths, in Congo, Cameroon and the Central African Republic.To date, scientists haven't found any mutations in the monkeypox virus that suggest it's more transmissible or lethal, although the number of changes detected show the virus has likely been spreading undetected for years.The version of the disease transmitting beyond Africa typically has a fatality rate of less than 1%, while the version seen in Africa can kill up to 10 percent of people affected.WHO is also creating a vaccine-sharing mechanism for monkeypox, which could see vaccines go to rich countries like Britain, which currently has the biggest outbreak beyond Africa.Some experts warned that could entrench the deep inequities seen between rich and poor countries during the coronavirus pandemic."France, Germany, the U.S. and U.K. already have a lot of resources and plenty of vaccines to deal with this and they don't need vaccines from WHO," said Dr. Irwin Redlener, an expert in disaster preparedness and response at Columbia University."What we should be doing is trying to help the countries in Africa where monkeypox has been endemic and largely neglected," he said. "Monkeypox is not Covid, but our attention should not be so distorted that it only becomes a problem when it is seen in rich countries." (AP)

Abortion foes, supporters map next moves after Roe reversal

Posted: 25 Jun 2022 05:53 PM PDT

A TEXAS group that helps women pay for abortions halted its efforts Saturday, June 25, 2022, while evaluating its legal risk under a strict state ban. Mississippi's only abortion clinic continued to see patients while awaiting a 10-day notice that will trigger a ban. Elected officials across the country vowed to take action to protect women's access to reproductive health care, and abortion foes promised to take the fight to new arenas.A day after the Supreme Court's bombshell ruling overturning Roe v. Wade ended the constitutional right to abortion, emotional protests and prayer vigils turned to resolve as several states enacted bans and both supporters and opponents of abortion rights mapped out their next moves.In Texas, Cathy Torres, organizing manager for Frontera Fund, a group that helps pay for abortions, said there is a lot of fear and confusion in the Rio Grande Valley near the U.S.-Mexico border, where many people are in the country without legal permission.That includes how the state's abortion law, which bans the procedure from conception, will be enforced. Under the law, people who help patients get abortions can be fined and doctors who perform them could face life in prison."We are a fund led by people of color, who will be criminalized first," Torres said, adding that abortion funds like hers that have paused operations hope to find a way to safely restart. "We just really need to keep that in mind and understand the risk."Tyler Harden, Mississippi director for Planned Parenthood Southeast, said she spent Friday and Saturday making sure people with impending appointments at the state's only abortion clinic — which featured in the Supreme Court case but is not affiliated with Planned Parenthood — know they don't have to cancel them right away. Abortions can still take place until 10 days after the state attorney general publishes a required administrative notice.Mississippi will ban the procedure except for pregnancies that endanger the woman's life or those caused by rape reported to law enforcement. The Republican speaker of the Mississippi House, Philip Gunn, said during a news conference Friday that he would oppose adding an exception for incest. "I believe that life begins at conception," Gunn said.Harden said she has been providing information about funds that help people travel out of state to have abortions. Many in Mississippi already were doing so even before the ruling, but that will become more difficult now that abortions have ended in neighboring states like Alabama. Right now Florida is the nearest "safe haven" state, but Harden said, "we know that that may not be the case for too much longer."At the National Right to Life convention in Atlanta, a leader within the anti-abortion group warned attendees Saturday that the Supreme Court's decision ushers in "a time of great possibility and a time of great danger."Randall O'Bannon, the organization's director of education and research, encouraged activists celebrate their victories but stay focused and continue working on the issue. Specifically, he called out medication taken to induce abortion."With Roe headed for the dustbin of history, and states gaining the power to limit abortions, this is where the battle is going to be played out over the next several years," O'Bannon said. "The new modern menace is a chemical or medical abortion with pills ordered online and mailed directly to a woman's home."Protests broke out for a second day in cities across the country, from Los Angeles to Oklahoma City to Jackson, Mississippi.In the LA demonstration, one of several in California, hundreds of people marched through downtown carrying signs with slogans like "my body, my choice" and "abort the court."Turnout was smaller in Oklahoma City, where about 15 protesters rallied outside the Capitol. Oklahoma is one of 11 states where there are no providers offering abortions, and it passed the nation's strictest abortion law in May."I have gone through a wave of emotions in the last 24 hours. ... It's upsetting, it's angry, it's hard to put together everything I'm feeling right now," said Marie Adams, 45, who has had two abortions for ectopic pregnancies, where a fertilized egg is unable to survive. She called the issue "very personal to me.""Half the population of the United States just lost a fundamental right," Adams said. "We need to speak up and speak loud."Callie Pruett, who volunteered to escort patients into West Virginia's only abortion clinic before it stopped offering the procedure after Friday's ruling, said she plans to work in voter registration in the hope of electing officials who support abortion rights. The executive director of Appalachians for Appalachia added that her organization also will apply for grants to help patients get access to abortion care, including out of state."We have to create networks of people who are willing to drive people to Maryland or to D.C.," Pruett said. "That kind of local action requires organization at a level that we have not seen in nearly 50 years."Fellow West Virginian Sarah MacKenzie, 25, said she's motivated to fight for abortion access by the memory of her mother, Denise Clegg, a passionate reproductive health advocate who worked for years at the state's clinic as a nurse practitioner and died unexpectedly in May. MacKenzie plans to attend protests in the capital, Charleston, and donate to a local abortion fund."She would be absolutely devastated. She was so afraid of this happening — she wanted to stop it," Mackenzie said, adding, "I'll do everything in my power to make sure that this gets reversed."The Supreme Court's ruling is likely to lead to abortion bans in roughly half the states.Since the decision, clinics have stopped performing abortions in Arizona, Alabama, Arkansas, Kentucky, Missouri, South Dakota, West Virginia and Wisconsin. Women considering abortions already had been dealing with the near-complete ban in Oklahoma and a prohibition after roughly six weeks in Texas.In Ohio, a ban on most abortions from the first detectable fetal heartbeat became law when a federal judge dissolved an injunction that had kept the measure on hold for nearly three years.Another law with narrow exceptions was triggered in Utah by Friday's ruling. Planned Parenthood Association of Utah filed a lawsuit against it in state court and said it would request a temporary restraining order, arguing it violates the state constitution.Gov. Tim Walz of Minnesota, where abortion remains legal, signed an executive order shielding people seeking or providing abortions in his state from facing legal consequences in other states. Walz also has vowed to reject requests to extradite anyone accused of committing acts related to reproductive health care that are not criminal offenses in Minnesota."My office has been and will continue to be a firewall against legislation that would reverse reproductive freedom," he said.In Fargo, North Dakota, the state's sole abortion provider faces a 30-day window before it would have to shut down and plans to move across the river to Minnesota. Red River Women's Clinic owner Tammi Kromenaker said Saturday that she has secured a location in Moorhead and an online fundraiser to support the move has brought in more than half a million dollars in less than three days.Republicans sought to downplay their excitement about winning their decades-long fight to overturn Roe, aware that the ruling could energize the Democratic base, particularly suburban women. Carol Tobias, president of National Right to Life, said she expects abortion opponents to turn out in huge numbers this fall.But Wisconsin Gov. Tony Evers, a Democrat, said Saturday he believes the issue will energize independents and he hopes to translate anger over Roe's demise into votes."Any time you take half the people in Wisconsin and make them second-class citizens," Evers said, "I have to believe there's going to be a reaction to that." (AP)

WHO considers declaring monkeypox a global health emergency

Posted: 25 Jun 2022 06:28 AM PDT

LONDON — The World Health Organization convenes its emergency committee Thursday to consider if the spiraling outbreak of monkeypox warrants being declared a global emergency.But some experts say the WHO's decision to act only after the disease spilled into the West could entrench the grotesque inequities that arose between rich and poor countries during the coronavirus pandemic.Declaring monkeypox to be a global emergency would mean the U.N. health agency considers the outbreak to be an "extraordinary event" and that the disease is at risk of spreading across even more borders, possibly requiring a global response. It would also give monkeypox the same distinction as the Covid-19 pandemic and the ongoing effort to eradicate polio.The WHO said it did not expect to announce any decisions made by its emergency committee before Friday.Many scientists doubt any such declaration would help to curb the epidemic, since the developed countries recording the most recent cases are already moving quickly to shut it down.Last week, WHO Director-General Tedros Adhanom Ghebreyesus described the recent monkeypox epidemic identified in more than 40 countries, mostly in Europe, as "unusual and concerning." Monkeypox has sickened people for decades in central and west Africa, where one version of the disease kills up to 10 percent of people infected. The version of the disease seen in Europe and elsewhere usually has a fatality rate of less than 1 percent and no deaths beyond Africa have so far been reported."If WHO was really worried about monkeypox spread, they could have convened their emergency committee years ago when it reemerged in Nigeria in 2017 and no one knew why we suddenly had hundreds of cases," said Oyewale Tomori, a Nigerian virologist who sits on several WHO advisory groups. "It is a bit curious that WHO only called their experts when the disease showed up in white countries," he said.Until last month, monkeypox had not caused sizeable outbreaks beyond Africa. Scientists haven't found any mutations in the virus that suggest it's more transmissible, and a leading adviser to the WHO said last month the surge of cases in Europe was likely tied to sexual activity among gay and bisexual men at two raves in Spain and Belgium.42 countriesTo date, the U.S. Centers for Disease Control and Prevention has confirmed more than 3,300 cases of monkeypox in 42 countries where the virus hasn't been typically seen. More than 80 percent of cases are in Europe. Meanwhile, Africa has already seen more than 1,400 cases this year, including 62 deaths.David Fidler, a senior fellow in global health at the Council on Foreign Relations, said the WHO's newfound attention to monkeypox amid its spread beyond Africa could inadvertently worsen the divide between rich and poor countries seen during Covid-19."There may be legitimate reasons why WHO only raised the alarm when monkeypox spread to rich countries, but to poor countries, that looks like a double standard," Fidler said. He said the global community was still struggling to ensure the world's poor were vaccinated against the coronavirus and that it was unclear if Africans even wanted monkeypox vaccines, given competing priorities like malaria and HIV."Unless African governments specifically ask for vaccines, it might be a bit patronizing to send them because it's in the West's interest to stop monkeypox from being exported," Fidler said.The WHO has also proposed creating a vaccine-sharing mechanism to help affected countries, which could see doses go to rich countries like Britain, which has the biggest monkeypox outbreak beyond Africa — and recently widened its use of vaccines.VulnerableTo date, the vast majority of cases in Europe have been in men who are gay or bisexual, or other men who have sex with men, but scientists warn anyone in close contact with an infected person or their clothing or bedsheets is at risk of infection, regardless of their sexual orientation. People with monkeypox often experience symptoms like fever, body aches and a rash; most recover within weeks without medical care.Even if the WHO announces monkeypox is a global emergency, it's unclear what impact that might have.In January 2020, the WHO declared COVID-19 an international emergency. But few countries took notice until March, when the organization described it as a pandemic, weeks after many other authorities did so.The WHO was later slammed for its multiple missteps throughout the pandemic, which some experts said might be prompting a quicker monkeypox response."After COVID, WHO does not want to be the last to declare monkeypox an emergency," said Amanda Glassman, executive vice president at the Center for Global Development. "This may not rise to the level of a COVID-like emergency, but it is still a public health emergency that needs to be addressed."Salim Abdool Karim, an epidemiologist and vice chancellor at the University of KwaZulu-Natal in South Africa, said the WHO and others should be doing more to stop monkeypox in Africa and elsewhere, but wasn't convinced that a global emergency declaration would help."There is this misplaced idea that Africa is this poor, helpless continent, when in fact, we do know how to deal with epidemics," said Abdool Karim. He said that stopping the outbreak ultimately depends on things like surveillance, isolating patients and public education."Maybe they need vaccines in Europe to stop monkeypox, but here, we have been able to control it with very simple measures," he said. (AP)
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