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Monkeypox, misinformation and mitigating a pandemic

Words by Jade Williams

The monkeypox outbreak in the summer of 2022 elicited worldwide concern, pushing the pharmaceutical industry into action to prevent the next potential pandemic. But how has pharma responded, and could it be doing more to support disproportionately affected communities?

When monkeypox was first detected in the UK in May 2022, the world collectively took a sharp intake of breath. Fresh off the back of COVID-19, was humanity prepared for yet another pandemic? The answer didn’t matter. Almost as quickly as it appeared, news of the outbreak faded, and the media turned its attention towards other, fresher stories – leaving monkeypox coverage to a minimum.

That does not mean, however, that monkeypox has disappeared. The virus has, at time of writing, infected almost 62,000 people across 105 countries and been classified by the World Health Organization (WHO) as a public health emergency of international concern. While the disease may have fallen off the front pages, its presence is still felt especially strongly by those in marginalised groups. The LGBTQ+ community has been disproportionately affected by this virus outbreak and has therefore received some unwarranted stigma from the public, with fake news articles leading to misconceptions in public opinion.

Mitigating misinformation

The extent of false information spreading about monkeypox has led some critics to brand it an infodemic: a term classified by the WHO as “too much information including false or misleading information in digital and physical environments during a disease outbreak” that causes “confusion and risk-taking behaviours harmful to health”. Infodemics can cause greater levels of vaccine hesitancy, stigma against sufferers of a disease and much more besides.

If you can’t change behaviours, then you can’t contain outbreaks

According to Michael Head, Senior Research Fellow, Southampton University: “The world is getting better at proactively countering the misinformation we know is going to arise.” But he adds that pharmaceutical companies must bolster their health campaigns to dispel any potential misinformation from rising and marginalising these groups even further. For example, efforts to combat harmful information around the HPV vaccine in the mid-2000s led to many more women getting vaccinated.

Behavioural change

Educating the public on the causes behind virus outbreaks and their associated prevention and treatment pathways is key in not only stopping unwarranted discrimination from spreading, but in aiding public health initiatives to drive behavioural change. As Head rightly notes: “If you can’t change behaviours, then you can’t contain outbreaks.”

While the spread of COVID-19 was driven by its respiratory nature, monkeypox is transmitted mainly through close contact with the virus’ characteristic blisters and scabs. As a result, controlling monkeypox has been much easier than COVID-19, but behavioural change has still been a crucial factor in driving containment. “Most of the affected groups say they have reduced sexual contact and changed behaviours,” comments Head, which, he states, “is the key to getting monkeypox under control”.

To combat misinformation surrounding monkeypox and set these behavioural changes into motion, some pharma companies, such as Gilead Sciences, have partnered with LGBTQ+ and human rights organisations to educate groups most affected by the disease on how to best avoid its transmission.

Is a monkeypox vaccine needed?

The spread of monkeypox may have been largely prevented through behavioural change, but fearing the impact of the next potential pandemic, vaccine developers were quick to jump-start a vaccine response to the virus when it emerged. Between May and July, an extension of the marketing authorisation for Bavarian Nordic’s smallpox vaccine Imvanex was applied for and granted by the European Commission for cross-protection against monkeypox. This rapid response was almost certainly a learned reaction from experiences lived during the COVID-19 pandemic, and it was certainly imperative even though the case fatality ratio for monkeypox sits relatively low at 3-6%.

The world is getting better at proactively countering the misinformation we know is going to arise

Still, Dr Richard Hatchett, Chief Executive Officer, Coalition for Epidemic Preparedness (CEPI), believes efforts must not end here. “Monkeypox’s global impact requires us to explore whether existing countermeasures, like currently stockpiled smallpox vaccines, will be sufficient to address the further spread of human monkeypox and to ensure that tools to support the array of potential developers are available,” he says. Pharma companies should work collaboratively with CEPI and other stakeholders in the coming months and years to ensure they are aligned on whether a dedicated monkeypox vaccine is necessary. Offering his opinion on the matter, Head states that “pharma will need to look at bolstering the development of new vaccines and supplies” if it hopes to eradicate the monkeypox virus outbreak completely.

Monkeypox has been endemic in some populations for years, particularly in west and central Africa, but arguably the world has only taken notice now that it has breached western waters. If more vaccines are repurposed or developed for the virus, vaccine equity will be key, and the Western world cannot stockpile vaccines and medications as it was criticised for doing during the COVID-19 pandemic. A collaborative step forward must be taken, hand in hand with all of the communities most affected by this re-emerging disease.

This article features in GOLD 24 – read the full issue here.

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