Top health officials say they are trying to limit the spread of the monkeypox virus while also preventing stigma against those most affected — particularly gay, bisexual and other men who have sex with men — but their messaging may be a part of the problem, according to some advocates.
More than 21,000 people, in over 70 countries, have contracted the virus, which causes painful sores and blisters among other symptoms. An estimated 98 per cent of confirmed cases are in men who have sex with men.
This week, the head of the World Health Organization (WHO), Tedros Adhanom Ghebreyesus, warned stigma “can be as dangerous as any virus and can fuel the outbreak.” At the same time, he urged men who have sex with men to reduce their number of sexual partners or to reconsider having new sexual partners “for the moment.”
The Public Health Agency of Canada (PHAC), which has reported at least 745 cases since the first two cases were detected in late May, also urged men who have sex with men to limit sexual partners, especially casual acquaintances.
“I think when we try to tell people ‘Stop doing this. Stop doing that,’ it doesn’t really work,” Devan Nambiar of the Gay Men’s Sexual Health Alliance in Toronto told CBC News. “It hasn’t worked in any infection.”
Devan Nambiar, manager of capacity building at the Gay Men’s Sexual Health Alliance in Toronto, said the stigma of HIV/AIDS is still prevalent after more than 40 years. (Submitted by Devan Nambiar)
It is important to make people aware of the risk factors so they can make informed decisions, and to be compassionate and concise in the messaging, he said, but not to stigmatise people for their sexual activity and behaviour – something gay men, in particular, have endured since the early years of the HIV/AIDS pandemic when the illness was widely considered a “gay disease.”
Lessons learned from that era have been applied to public health care today, but there are criticisms that history is repeating itself with the handling of the monkeypox outbreak.
Some advocates attending the International AIDS Conference (AIDS 2022) in Montreal from July 29 – Aug. 2 say health officials need to prevent the perception that a viral threat, like HIV/AIDS or monkeypox, only affects one portion of the population.
“[We] lived that with the HIV epidemic. We certainly saw that with COVID-19. Let’s not do it with monkeypox, right?” said Linda-Gail Bekker, deputy director of the Desmond Tutu HIV Centre at the University of Cape Town’s Institute of Infectious Disease and Molecular Medicine in South Africa and a past president of the International AIDS Society, which organized the AIDS 2022 gathering.
Engagement key to combating health threats
The conference returns to Montreal for the first time since 1989, a time when access was limited to drugs that could prolong the lives of people infected with HIV. The majority of those dying from AIDS at that time were gay, bisexual and other men who have sex with men, transgender women, as well as injection drug users.
WATCH | Is monkeypox messaging missing the mark?
Concerns over public health messaging around monkeypox
2 days ago
Duration 2:05
As monkeypox cases spread worldwide, overwhelmingly among men who have sex with men, there is growing concern that public health messages targeting that community have missed the mark.
The monkeypox virus, however, is not a sexually transmitted infection like HIV, the virus that causes AIDS; it’s transmitted through close personal contact with someone who is infected, but also through direct contact with materials that have touched the bodily fluids or sores of an infected person, such as bed sheets or clothing.
Bekker believes that without proper communication and engagement with affected groups — whether it concerns HIV/AIDS or monkeypox — there is a risk of discrimination that may lead to people not seeking or being able to access the services they need.
Gay men take health into their own hands
Nambiar, who will also be attending the AIDS 2022 conference which begins Friday, said gay and bisexual men have long been their own health-care advocates, having to “figure a lot of things out for ourselves” because of “indifference” to the LGBTQ community.
“We have led the work in many things actually, in terms of getting self checks, taking [on] advocacy, taking autonomy in terms of our well-being, fighting for our rights,” he told CBC News.
With monkeypox, he said, gay and bisexual men have been speaking up loudly since early on, calling for paid leave so they can properly quarantine, and to demand access to testing and vaccines.
He said it’s an individual decision to get vaccinated to protect against monkeypox, something about 27,000 eligible people have done so far in Canada, according to PHAC.
Some public health authorities have set up pop-up vaccination clinics at locations frequented by men who have sex with men, including gay bars, bathhouses and cruising areas. The response to monkeypox has been “pretty decent” in Canada, Nambiar said, though he can’t say the same for other countries.
In the U.S., which now has the highest number of recorded cases of monkeypox, the response to the outbreak has been criticized. One AIDS advocate compared the U.S. government’s initial response to monkeypox to their handling of the COVID-19 pandemic, when the country led the world in deaths and less than 70 per cent of the population is fully vaccinated.
LISTEN | Dr. Anthony Fauci on HIV/AIDS, monkeypox and COVID-19:
The Current20:50Dr. Anthony Fauci on the lessons learned from COVID-19, HIV/AIDS and monkeypox
We talk to Dr. Anthony Fauci about the COVID-19 pandemic, the lessons he learned from the fight against HIV/AIDS, and what the world needs to do to get rising monkeypox cases under control.
HIV/AIDS overshadowed by converging threats
As fears grow over monkeypox, and with COVID-19 case numbers again rising, health professionals gathering in Montreal worry about whether the world will be able to meet the UN’s 2030 target to end HIV/AIDS as a global health concern.
There were an estimated 38.4 million people living with HIV/AIDS globally in 2021, with approximately 1.5 million new HIV infections last year. The United Nations said that is a million cases higher than global targets and a sign of “faltering progress.”
This week, at the launch of a new UNAIDS report titled In Danger, UNAIDS Executive Director Winnie Byanyima warned “the response to the AIDS pandemic has been derailed by global crises,” including the war in Ukraine and international economic instability.
“The actions needed to end AIDS are also key for overcoming other pandemics,” she said.
Over the four days of the AIDS 2022 conference, there will be a push to “counter apathy” in combating HIV/AIDS globally and a call “to re-engage and follow the science.”
Winnie Byanyima, executive director of UNAIDS, holds up the 2022 update on the global AIDS situation at a news conference in Montreal, ahead of the World AIDS Conference this weekend. (Ryan Remiorz/The Canadian Press)
“Some of this is going on the offensive,” said Bekker, noting there is an additional challenge with the polarization around science that has emerged in the COVID-19 pandemic.
Nambiar said some of that apathy towards HIV/AIDS comes from being “inundated with viruses,” with the mutated variants and subvariants of COVID-19, and now monkeypox.
But he said one of the important lessons that has been learned over the years, that certainly applies today, is that a successful response to a public health emergency requires cooperation between governments, public health workers and community organizations. That didn’t happen immediately with HIV/AIDS, but he sees it developing now in response to monkeypox.
Though there have been remarkable achievements in the last four decades to prevent the transmission of HIV and allow people to live with the infections as a chronic illness, Bekker wants to remind people that doesn’t mean the HIV/AIDS pandemic is over.
“I would say we’ve got the hardest mile to come,” she told CBC News. “We really do need to gird our loins, pull ourselves together as a community and say, ‘What can we do to reach that last mile?'”
The Canadian government says it will donate up to 200,000 vaccine doses to fight the mpox outbreak in Congo and other African countries.
It says the donated doses of Imvamune will come from Canada’s existing supply and will not affect the country’s preparedness for mpox cases in this country.
Minister of Health Mark Holland says the donation “will help to protect those in the most affected regions of Africa and will help prevent further spread of the virus.”
Dr. Madhukar Pai, Canada research chair in epidemiology and global health, says although the donation is welcome, it is a very small portion of the estimated 10 million vaccine doses needed to control the outbreak.
Vaccine donations from wealthier countries have only recently started arriving in Africa, almost a month after the World Health Organization declared the mpox outbreak a public health emergency of international concern.
A few days after the declaration in August, Global Affairs Canada announced a contribution of $1 million for mpox surveillance, diagnostic tools, research and community awareness in Africa.
On Thursday, the Africa Centres for Disease Control and Prevention said mpox is still on the rise and that testing rates are “insufficient” across the continent.
Jason Kindrachuk, Canada research chair in emerging viruses at the University of Manitoba, said donating vaccines, in addition to supporting surveillance and diagnostic tests, is “massively important.”
But Kindrachuk, who has worked on the ground in Congo during the epidemic, also said that the international response to the mpox outbreak is “better late than never (but) better never late.”
“It would have been fantastic for us globally to not be in this position by having provided doses a much, much longer time prior than when we are,” he said, noting that the outbreak of clade I mpox in Congo started in early 2023.
Clade II mpox, endemic in regions of West Africa, came to the world’s attention even earlier — in 2022 — as that strain of virus spread to other countries, including Canada.
Two doses are recommended for mpox vaccination, so the donation may only benefit 100,000 people, Pai said.
Pai questioned whether Canada is contributing enough, as the federal government hasn’t said what percentage of its mpox vaccine stockpile it is donating.
“Small donations are simply not going to help end this crisis. We need to show greater solidarity and support,” he said in an email.
“That is the biggest lesson from the COVID-19 pandemic — our collective safety is tied with that of other nations.”
This report by The Canadian Press was first published Sept. 13, 2024.
Canadian Press health coverage receives support through a partnership with the Canadian Medical Association. CP is solely responsible for this content.
HALIFAX – The Nova Scotia government says it could be months before it reveals how many people are on the wait-list for a family doctor.
The head of the province’s health authority told reporters Wednesday that the government won’t release updated data until the 160,000 people who were on the wait-list in June are contacted to verify whether they still need primary care.
Karen Oldfield said Nova Scotia Health is working on validating the primary care wait-list data before posting new numbers, and that work may take a matter of months. The most recent public wait-list figures are from June 1, when 160,234 people, or about 16 per cent of the population, were on it.
“It’s going to take time to make 160,000 calls,” Oldfield said. “We are not talking weeks, we are talking months.”
The interim CEO and president of Nova Scotia Health said people on the list are being asked where they live, whether they still need a family doctor, and to give an update on their health.
A spokesperson with the province’s Health Department says the government and its health authority are “working hard” to turn the wait-list registry into a useful tool, adding that the data will be shared once it is validated.
Nova Scotia’s NDP are calling on Premier Tim Houston to immediately release statistics on how many people are looking for a family doctor. On Tuesday, the NDP introduced a bill that would require the health minister to make the number public every month.
“It is unacceptable for the list to be more than three months out of date,” NDP Leader Claudia Chender said Tuesday.
Chender said releasing this data regularly is vital so Nova Scotians can track the government’s progress on its main 2021 campaign promise: fixing health care.
The number of people in need of a family doctor has more than doubled between the 2021 summer election campaign and June 2024. Since September 2021 about 300 doctors have been added to the provincial health system, the Health Department said.
“We’ll know if Tim Houston is keeping his 2021 election promise to fix health care when Nova Scotians are attached to primary care,” Chender said.
This report by The Canadian Press was first published Sept. 11, 2024.
ST. JOHN’S, N.L. – Newfoundland and Labrador‘s chief medical officer is monitoring the rise of whooping cough infections across the province as cases of the highly contagious disease continue to grow across Canada.
Dr. Janice Fitzgerald says that so far this year, the province has recorded 230 confirmed cases of the vaccine-preventable respiratory tract infection, also known as pertussis.
Late last month, Quebec reported more than 11,000 cases during the same time period, while Ontario counted 470 cases, well above the five-year average of 98. In Quebec, the majority of patients are between the ages of 10 and 14.
Meanwhile, New Brunswick has declared a whooping cough outbreak across the province. A total of 141 cases were reported by last month, exceeding the five-year average of 34.
The disease can lead to severe complications among vulnerable populations including infants, who are at the highest risk of suffering from complications like pneumonia and seizures. Symptoms may start with a runny nose, mild fever and cough, then progress to severe coughing accompanied by a distinctive “whooping” sound during inhalation.
“The public, especially pregnant people and those in close contact with infants, are encouraged to be aware of symptoms related to pertussis and to ensure vaccinations are up to date,” Newfoundland and Labrador’s Health Department said in a statement.
Whooping cough can be treated with antibiotics, but vaccination is the most effective way to control the spread of the disease. As a result, the province has expanded immunization efforts this school year. While booster doses are already offered in Grade 9, the vaccine is now being offered to Grade 8 students as well.
Public health officials say whooping cough is a cyclical disease that increases every two to five or six years.
Meanwhile, New Brunswick’s acting chief medical officer of health expects the current case count to get worse before tapering off.
A rise in whooping cough cases has also been reported in the United States and elsewhere. The Pan American Health Organization issued an alert in July encouraging countries to ramp up their surveillance and vaccination coverage.
This report by The Canadian Press was first published Sept. 10, 2024.
