Opinion: Hoarding monkeypox vaccines in wealthy non\u002Dendemic countries while neglecting disease spread and increasing cases in endemic countries is a strategy that is doomed to fail in the long\u002Dterm
Glaringly, almost all the attention is on cases in wealthy countries. The tragic deaths and the increasing burden of the disease in impoverished regions in the world continue to be largely neglected.
In the setting of international neglect, the numbers of cases and deaths from monkeypox in central and western regions of Africa have increased dramatically since the 1970s, when the first cases were diagnosed in the Democratic Republic of the Congo. The number of cases has increased more than 10-fold over the past 10 years. In 2017, after 40 years without any cases, monkeypox re-emerged in Nigeria.
The reasons for the increasing number of cases in Africa are likely related to ecology, deforestation, civil unrest, and poverty — which force more interactions between people and rodents/animals that are the natural hosts of the monkeypox virus. Combined with the cessation of smallpox vaccination in the 1980s and the subsequent waning of immunity, this means that populations are now more susceptible to monkeypox.
The relative neglect of deaths and rising numbers of cases in other regions of the world where the virus is endemic continues to be a problem. It is in our collective self-interest and our health security to ensure that access to healthcare, surveillance, vaccination and therapeutic interventions primarily reach regions of the world most impacted by this disease.
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