Monkeypox is very unpleasant and it spreads very fast, but it’s not a real killer: 16,000 cases in 75 countries in only two months is impressive, but there have been only five deaths.
Yet the World Health Organisation (WHO) has just declared monkeypox a global health emergency, which is a big deal. That seems disproportionate, but there’s a reason.
“Covid-19 is broadly viewed as being a ‘once in a lifetime’ or ‘once in a century’ pandemic. Modeling work based on historical data shows that this is not necessarily the case,” reported the epidemiological start-up Metabiota last year. That’s because “the frequency of ‘spill-over’ infectious diseases like Covid is steadily increasing.”
It’s increasing because quick-killer pandemic diseases only started thriving in human societies when we began living together in large numbers.
The natural home of those diseases were birds and animals that lived in big flocks and herds: lots of potential victims to sustain the transmission. But when human beings created big civilisations and domesticated some of those animals, the pandemic diseases happily transferred across and thrived amongst us too.
For most of recorded history, successful transfers were rare: new killer pandemics only came along every few centuries. However, now that there are eight billion people and millions criss-cross the planet every day, the disease vectors spread much more efficiently.
According to Metabiota’s calculations, it’s even odds that we will have another new pandemic on the scale of Covid-19 in the next 25 years. In other words, the probability of another global pandemic like that is between 2.5% and 3.3% every year. It could even arrive next year.
Monkeypox is not that disease. Despite its rapid spread, it is transmitted mainly between men who have sex with men. There is already a vaccine for it (the same one that eradicated smallpox, which no longer exists in the wild). And hardly anybody dies from it.
So WHO director-general Dr Tedros Adhanom Ghebreyesus had some explaining to do when he broke a stalemate at his ‘emergency committee’ and decreed that monkeypox is a global emergency.
He explained that it was to speed up research on “the new modes of transmission that have allowed it to spread”, and to press countries to use vaccines and other measures to limit the numbers infected. These are all sensible things to do, but they really don’t justify declaring a global health emergency.
What Ghebreyesus didn’t say is that he really intends it as a reminder of our peril and a spur to action. The whole pandemic response system needs an exercise that incorporates all the lessons learned from our stumbling response to Covid, and monkeypox provides an excuse to do it.
Ghebreyesus is manipulating the system in an attempt to get the world to build better systems for containing dangerous emergent diseases in general. You can see his point, because we haven’t learned enough from our harrowing experience with Covid.
The vaccines were developed faster than in any previous pandemic, and two-thirds of the world’s population has been fully vaccinated in sixteen months, but the rate of immunity in the poorest countries is abysmal.
Just spending one-hundredth of what the world spent on fighting Covid to improve global readiness for the next pandemic – building local vaccine production facilities, regional labs with good analytical capabilities, and stronger reporting networks – could spare us another two years of the misery and loss we had with this pandemic.
If that’s Ghebreyesus’s real goal with this monkeypox ‘emergency’, it’s all right with me.