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WHO declares monkeypox Public Health Emergency

“There’s clear risk of further international spread, although the risk of interference with international traffic remains low for the moment”

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Sign being carried during the Berlin Pride parade on July 23, 2022. (Washington Blade photo by Michael K. Lavers)

The World Health Organization’s Director-General Dr. Tedros Adhanom Ghebreyesus declared the escalating global monkeypox outbreak a Public Health Emergency of International Concern (PHEIC) on Saturday. This is an escalated status but below the requirements needed for a declaration of a pandemic, in part over its low death rates.

Currently, the vast majority of reported cases are in the WHO European Region. “WHO/Europe remains committed to partnering with countries and communities to address the outbreak with the required urgency,” Dr. Tedros said during a media briefing.

In laying out reasons for the declaration the WHO head noted; ā€œWe have an outbreak that has spread around the world rapidly through new modes of transmission, about which we understand too little,ā€ Tedros said. ā€œI know this has not been an easy or straightforward process and that there are divergent views.ā€

There had been reservations by the health agency’s expert committee who said the monkeypox outbreak did not yet amount to an international emergency in a meeting in June. Tedros had reconvened that committee in a special session this past Thursday.

ā€œA month ago, I convened the Emergency Committee under the International Health Regulations to assess whether the multi-country monkeypox outbreak represented a public health emergency of international concern,ā€ Tedros told reporters. “At that meeting, while differing views were expressed, the committee resolved by consensus that the outbreak did not represent a public health emergency of international concern.”

“At the time, 3040 cases of monkeypox had been reported to WHO, from 47 countries. Since then, the outbreak has continued to grow, and there are now more than 16 thousand reported cases from 75 countries and territories, and five deaths,” he added.

“In light of the evolving outbreak, I reconvened the committee on Thursday of this week to review the latest data and advise me accordingly. I thank the committee for its careful consideration of the evidence, and issues,” Tedros continued.

“On this occasion, the committee was unable to reach a consensus on whether the outbreak represents a public health emergency of international concern. The reasons the committee members gave for & against are laid out in the report we are publishing today.”

“Under the International Health Regulations, I am required to consider five elements in deciding whether an outbreak constitutes a public health emergency of international concern.”

“First, the information provided by countries ā€“ which in this case shows that this virus has spread rapidly to many countries that have not seen it before. Second, the three criteria for declaring a public health emergency of international concern under the International Health Regulations, which have been met. Third, the advice of the Emergency Committee, which has not reached consensus. Fourth, scientific principles, evidence and other relevant information ā€“ which are currently insufficient and leave us with many unknowns. Fifth, the risk to human health, international spread and the potential for interference with international traffic,” Tedros told the press laying out the foundation to his decision.

“WHOā€™s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where we assess the risk as high,” he said adding “There is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment.”

“So in short, we have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little and which meets the criteria in the International Health Regulations.” The WHO chief then noted “For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern.”

WHO Director-General Dr. Tedros Adhanom Ghebreyesu
(Photo credit: WHO)

Tedros then pivoted to WHO recommendations for the international public health community in addressing the outbreak.

“Accordingly, I have made a set of recommendations for four groups of countries: First [group], those that have not yet reported a case of monkeypox, or have not reported a case for more than 21 days. Second [group], those with recently imported cases of monkeypox and that are experiencing human-to-human transmission. This includes recommendations to implement a coordinated response to stop transmission and protect vulnerable groups; to engage & protect affected communities; To intensify surveillance & public health measures; To strengthen clinical management & infection prevention & control in hospitals & clinics to accelerate research into the use of vaccines, therapeutics & other tools; And recommendations on international travel. The third group of countries is those with transmission of monkeypox from animals to humans and the fourth is countries with manufacturing capacity for vaccines and therapeutics.”

Tedros acknowledged the work of the committee saying: “I thank the Emergency Committee for its deliberations and advice. I know this has not been an easy or straightforward process, and that there are divergent views among the members. “The International Health Regulations remains a vital tool for responding to the international spread of disease. But this process demonstrates once again that this vital tool needs to be sharpened to make it more effective.”

“Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners,” he said. “That means that this is an outbreak that can be stopped with the right strategies in the right groups.”

“Itā€™s therefore essential that all countries work closely with communities of men who have sex with men, to design & deliver effective information & services, and to adopt measures that protect both the health, human rights & dignity of affected communities,” Tedros said and then warned, “”Stigma and discrimination can be as dangerous as any virus.”

The WHO Director-General’s full statement is linked here: (WHO)

The Centers for Disease Control and Prevention released a statement saying that the agency was ā€œsupportiveā€ of WHOā€™s emergency declaration and hoped it would galvanize international action to stamp out the outbreaks. The U.S. has reported more than 2,800 monkeypox cases and sent more than 370,000 vaccine doses to U.S. states reporting cases.

Speaking with reporters Friday, Jennifer McQuiston the Deputy Director for High Consequence Pathogens and Pathology at the Centers for Disease Control and Prevention said that two cases of the monkeypox virus have been diagnosed in children.

ā€œWe became aware of these cases just this week, and weā€™ve been working with the jurisdictions to understand more about these cases,ā€ McQuiston said.

In a Washington Post Live session Friday, CDC Director Walensky, while discussing the highly contagious Omicron BA.5 coronavirus variant and the ongoing monkeypox outbreak, noted that the CDC was made aware of the cases adding that both children ā€œare doing well.ā€ 

McQuiston said that the agency determined that both cases were ā€œlikely the result of household transmissionā€ and ā€œhad no contact with each other.ā€

The agency is now aware of at least eight cases in people who identify as cisgender women, McQuiston said. Most cases so far have been among men who have sex with men. The number of cases as of July 22 is a total of 2,891 in the U.S. in 44 states and territories including the District of Columbia.

ā€œThere is no evidence to date that weā€™re seeing this virus spread outside of those populations to any degree, and I think that the primary drivers for this infection in the U.S. remain in the gay, bisexual, and men who have sex with men communities right now,ā€ McQuiston added.

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Health

UNAIDS to commemorate Zero Discrimination Dayā€™s 10th anniversary

UN agency urges global action to protect human rights

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A UNAIDS anti-discrimination exhibit at Tocumen International Airport in Panama in 2018. (Washington Blade photo by Michael K. Lavers)

As the world marks the 10th anniversary of Zero Discrimination Day; UNAIDS is sounding the alarm on the increasing threats to human rights, calling for renewed efforts to protect the rights of all individuals as a fundamental step towards ensuring health for everyone.

Established by UNAIDS a decade ago, Zero Discrimination Day aims to promote equality and fairness regardless of gender, age, sexuality, ethnicity or HIV status. The progress achieved over the past years is now in jeopardy, however, due to rising attacks on the rights of women, LGBTQ people and other marginalized communities.

UNAIDS Executive Director Winnie Byanyima emphasized the critical link between protecting human rights and safeguarding public health. 

“The attacks on rights are a threat to freedom and democracy and are harmful to health,ā€ she said in a press release. ā€œStigma and discrimination obstruct HIV prevention, testing, treatment and care and hold back progress towards ending AIDS by 2030. It is only by protecting everyoneā€™s rights that we can protect everyoneā€™s health.”

Despite challenges, there has been notable progress. 

At the onset of the AIDS pandemic more than 40 years ago, two-thirds of countries criminalized consensual same-sex sexual relations. They are now decriminalized in two-thirds of countries. An additional 38 countries around the world have pledged to end HIV-related stigma and discrimination, contributing to positive changes that include 50 million more girls attending school compared to 2015.

To sustain and enhance these advancements; UNAIDS urges global support for womenā€™s rights movements, LGBTQ rights, racial justice, economic justice, climate justice and peace initiatives. By standing with communities advocating for their rights, the U.N. aims to reinforce the collective effort towards a more inclusive and equitable world.

Zero Discrimination Day is observed on March 1.

Events and activities that will take place around the world throughout the month will serve as reminders of the essential lesson and call to action: Protecting everyoneā€™s health is synonymous with protecting everyoneā€™s rights.

“Through upholding rights for all, we will be able to achieve the Sustainable Development Goals and secure a safer, fairer, kinder and happier world ā€” for everyone,” said Byanyima.

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Health

New CDC report finds transgender women at higher risk for HIV

More than 1,600 people in seven cities surveyed

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The Centers for Disease Control and Prevention in Atlanta (Photo courtesy of the CDC)

The Centers for Disease Control and Prevention issued a new study report this week that revealed that restricted by employment and housing discrimination and lack of access to needed gender-affirming healthcare for transgender women increasing the risk of contracting HIV. 

Researchers reviewed data from a 2019-2020 survey, theĀ National HIV Behavioral Surveillance Among Transgender Women, which found that the demographics of HIV/AIDS have been disproportionally high, especially among Black and Latina trans women, who had experienced employment and housing discrimination coupled with lack of access to gender-affirming healthcare.

The Jan. 25Ā Morbidity and Mortality Weekly Report was based on data studies of more than 1,600 trans women in seven major urban locales. Participants from Atlanta, Los Angeles, New Orleans, New York, Philadelphia, San Francisco and Seattle were chosen by referrals from people and community-based organizations who knew or were part of the local population of trans women.

The studyā€™s researchers noted: ā€œEmployment discrimination occurs at the overlapping nexus of poverty, homelessness, incarceration, health insurance, disability, food insecurity and survival sex work. These issues are interconnected.ā€

The study stated that trans womenā€™s inability to access quality healthcare, including gender-affirming treatment or access to PrEP, and can expose them to potential incarceration as many turn to ā€œsurvival sex workā€ and violence, which increases the risk of contracting HIV. 

The studyā€™s authorā€™s pointed out: ā€œWhen economically marginalized transgender women are refused employment, this refusal cyclically contributes to economic hardships. This analysis ā€¦demonstrates the importance of transgender women working and living with dignity and without fear of unfair treatment.ā€

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Health

A Whole New Perspective on Well-Being

The Matherā€™s team recognizes that everyoneā€™s wellness journey is completely unique to their life experiences and influences.

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The Mather is incorporating biophilic designā€”a design approach to facilitate access to nature or things that replicate natural patterns.

Itā€™s easy to spot the distinctive, elegant silhouette of The Mather, a Life Plan Community for those 62+ opening this spring in Tysons, Virginia. What is not apparent to the naked eye is The Matherā€™s unique wellness philosophy, which is literally built into the community.Ā 

The Matherā€™s team recognizes that everyoneā€™s wellness journey is completely unique to their life experiences and influences.

Nature is one of the important factors that contribute to well-being. So The Mather is incorporating biophilic designā€”a design approach to facilitate access to nature or things that replicate natural patterns. This can include interior spaces with sightlines to a garden, choosing natural wood and stone as interior materials, or incorporating fragrant flowers and plants indoors to spark memories and provide tactile opportunities such as gardening.Ā 

Residents of The Mather will be able to select from plentiful amenities, programs, and other offerings to target their personal wellness goals and preferences.

ā€œProviding biophilic design within interior settings connects residents to the natural world,ā€ says Mary Leary, CEO and President of Mather, the organization behind The Mather. ā€œResearch shows that a connection to nature provides positive benefits to mental states and overall well-being. At The Mather, biophilic design is the intersection of buildings and programs with nature in an urban setting.ā€

ā€œThe Mather is attracting a diverse group of older adults,ā€ says Mary. ā€œAs a result, we aim to incorporate wellness practices from around the world, including Wyda movement theory of the Celtic Druids, which helps people achieve harmony with nature and contentment through mindfulness.ā€ This holistic regenerative approach is similar to Qi Gong and yoga, while born in a different part of the world. Mather Institute has a special focus on mindfulness to support older adultsā€™ practice of present moment awareness, which can lead to increased overall well-being, compassion, and joy.

A very different example of a wellness offering at The Mather is the Gharieni Welnamis spa wave bed, which uses computer-controlled vibrational therapy and audio frequencies to train the brain to relax. ā€œThe bed increases mindfulness, concentration, and creativityā€”all of which support our mission of creating Ways to Age Well,SMā€ says Mary.

These and other personalized ways to wellness will ensure that residents of The Mather can choose from seemingly countless ways to focus on their well-being. In other words, the skyā€™s the limit!

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