As Congo grapples with its most substantial outbreak of monkeypox (mpox), scientists caution that discrimination against gay and bisexual men could exacerbate the situation. Unlike previous instances where the virus primarily affected individuals in contact with diseased animals, the World Health Organization (WHO) reported sexual transmission of mpox in Congo in November. This revelation signifies a significant departure, with most of the approximately 91,000 people infected globally in 2022 being gay or bisexual men.
Sexual Transmission Challenges in Africa
Scientists, including Dimie Ogoina from Niger Delta University, highlight potential challenges due to the unwillingness to report symptoms in Africa. Homosexuality being prohibited by law in many African regions might deter individuals from seeking help if they suspect mpox infection. Ogoina emphasizes the need to address the underground nature of the outbreak, as underreporting hampers effective monitoring and containment efforts.
Security Concerns and Underestimation
While WHO officials identified sexually transmitted mpox cases in Congo last spring, there has been historical underestimation of the virus’s potential for sexual transmission in Africa. Ogoina and his colleagues first raised concerns about mpox spreading through sex in 2019. Gaps in monitoring and challenges in estimating sex-linked cases make it crucial to reassess and address the situation comprehensively.
Inadequate Awareness and Missed Cases
During a recent visit to Congo to assess the outbreak, WHO officials discovered a lack of awareness among health workers regarding the sexual transmission of mpox. This resulted in missed cases and underlines the need for increased education and awareness campaigns to ensure proper identification and management of mpox cases.
Vaccination Challenges in Africa
Amidst efforts to combat the outbreak, mass vaccination programs, similar to those in Western countries, may face challenges in Africa due to stigma against gay communities. Dr. Boghuma Titanji emphasizes the importance of finding ways to administer shots without stigmatizing at-risk populations. Regulatory issues and limited vaccine supplies add complexity to the situation, with the only authorized vaccine being Denmark’s Bavarian Nordic.
Addressing Outbreaks and Long-Term Solutions
Scientists warn that without greater efforts to curb the outbreaks in Africa, mpox could continue to infect new populations and potentially spark outbreaks in other countries. Oyewale Tomori suggests that stronger monitoring, improved laboratory networks, and better diagnostic supplies could be more beneficial to the continent than vaccines. The parallel drawn to the HIV pandemic highlights the importance of addressing outbreaks promptly to prevent the virus from persisting and resurfacing.
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