A laboratory worker takes the reagent for a test to detect monkeypox RUNGROJ YONGRIT (EFE)
Brazil is the country in Latin America with the most cases of monkeypox. There are 2,584 confirmed cases, according to the latest data from the Health Ministry, updated on Friday. The first was discovered on June 8 and at the moment there was only one deceased, a 41-year-old man who was being treated with chemotherapy for cancer in the city of Belo Horizonte. Most cases, authorities stress, are mild and should not trigger social panic.
This week the ministry raised the alert level to level three, the final step before declaring a national health emergency, as was the case with the Covid-19 pandemic. The current alert level is being given because cases are being transmitted in the community, there are no drugs available to treat or prevent the disease and because the impact on the various management areas of the public health system requires a broad government response. “It is a situation of exceptional seriousness,” the ministry’s internal document, published a few days ago, points out.
The Brazilian government is currently negotiating with the Pan American Health Organization (PAHO) to buy 50,000 doses of the vaccine, produced by a Danish laboratory. According to Health Minister Marcelo Queiroga, the first doses could arrive in September and will go exclusively to healthcare professionals who handle patient samples and people in direct contact with patients. A massive vaccination campaign like the one carried out with Covid-19 is out of the question. Partly because there are no vaccines for everyone, either in Brazil or in the rest of the world. Production ceased in 1980 with the eradication of smallpox ordered by the World Health Organization (WHO).
“The fact that there aren’t enough vaccines isn’t anyone’s fault, it’s not because they don’t want to negotiate or don’t want to buy, it’s because there aren’t any,” explains the secretary of health science, research and development of the state government in a telephone conversation from São Paulo, David Uip. In contrast to the Bolsonaro government’s disastrous management of the Covid-19 pandemic, which was marked by a lack of coordination and interest in vaccines, this time there seems to be more harmony between São Paulo and the central government. “We are very well networked, we talk on the phone practically every day,” says the infectiologist.
The state of São Paulo has been hardest hit by the disease (1,820 cases according to the current tally) and has been the one that has responded the most. This week she launched a plan that includes 93 rearguard hospitals, training more than 3,000 health professionals and a 24-hour service to dispel doubts about the diagnosis and clinical management of monkeypox patients.
In addition, the São Paulo Butantan Institute set up a committee to begin work on a vaccine against the disease. The Oswaldo Cruz Foundation in Rio de Janeiro also claims to have the capacity to manufacture the vaccine if deemed strategic by the Health Ministry. The two are leading public bodies, they are among the largest vaccine manufacturers in Latin America and in recent months tens of millions of vaccines against Covid-19 have come out of their facilities.
But in the absence of vaccines, it remains to focus on awareness for now, Uip stresses. The renowned infectiologist recalls that the disease has very general symptoms a priori (fever, headache, swollen glands…) but that it becomes more eloquent when the spots appear on the skin. Awareness campaigns are being worked on, but are not easy to implement. The reason is least strange: Brazil is facing elections in October and the electoral law has prevented institutional advertising since July 2nd. “We are trying to speak to the electoral courts because there is a health emergency, awareness-raising is essential,” says Uip.
In his opinion, the greatest challenge is to communicate transparently without stigmatizing parts of the population. At the moment, most cases of monkeypox occur in men who have sex with men, but the Science Minister is asking that gay men not be singled out, especially as circumstances could change shortly. The entire population is exposed. Monkeypox is not a sexually transmitted disease, it is transmitted through skin contact. “We must not make mistakes again,” he says, referring to the stigma that this group suffered decades ago with HIV.
President Jair Bolsonaro, on the other hand, dedicated his only reference to the disease to a homophobic joke. During a lengthy conversation on a podcast, he taunted the host when he said he would be gay if he could get vaccinated. Two trans councilors from the left-wing Socialism and Freedom Party (PSOL), Erika Hilton and Natasha Ferreira, denounced Bolsonaro to prosecutors for homophobia. “No type of negative stigma and violence, from the most subtle to the most explicit, can go unpunished,” Hilton told the Estado de São Paulo newspaper.