As monkeypox spreads, veteran activists say officials haven’t learned lessons from the AIDS crisis

As the incidence of monkeypox increases worldwide, four pioneering AIDS activists watch in awe and nostalgia.

Some of the similarities between the two viruses speak for themselves. Like the strain of HIV that started the AIDS pandemic in the late 1970s, the current outbreak of monkeypox emerged from sub-Saharan Africa and is found overwhelmingly in MSM living in the world’s major cities. While epidemiologists have not fully understood how the current outbreak of monkeypox spreads, recent research indicates sexual transmission of the infection.

Four leading AIDS activists in the 1980s and 1990s assert that other, less obvious, similarities occur in real time.

Photo: People hold signs representing the numbers of AIDS victims at a rally in support of AIDS victims in Central Park in New York City on August 8, 1983 (Allan Tannenbaum file/Getty Images)

As in the early days of the AIDS crisis, they argue that government messaging about the outbreak was flawed, gay men were shocked and public health officials failed to defeat a serious disease afflicting the LGBTQ community.

“It feels like deja vu,” said gay rights activist Peter Tatchell, who was a prominent member of the UK’s Gay Liberation Front. “It is clear that lessons from the AIDS and Covid crisis have not been learned.”

Public health officials around the world were slow to combat AIDS when it first began to appear in men who had sex with men during the late 1970s. The United States did not release the world’s first government report on infectious disease until June 5, 1981, in the Morbidity and Mortality Weekly Report, a government bulletin on baffling disease cases.

“From October 1980 to May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed pneumonia at 3 different hospitals in Los Angeles, California,” the report read. Two patients died.

Three years later, the US government announced the development of an AIDS test, as well as a vaccine that did not come to fruition. By 1985, an estimated 12,000 Americans had died of the disease.

Similarly, activists argue that the global response to monkeypox taming has been too slow to limit the swell in case numbers — more than 20,500 cases of the current monkeypox outbreak have been reported globally in 77 countries and territories since the beginning of May, according to the Centers for Disease Control and Prevention. Of which.

No one has died from monkeypox outside of the 11 African countries where the infectious disease has become endemic since its discovery in 1970. However, a large proportion of patients with monkeypox were hospitalized due to severe pain from the blister-like sores that commonly develop.

Since the first cases were discovered in May, the United States has distributed nearly 200,000 genus vaccines — a two-dose vaccine to prevent smallpox and monkeys — to the highest-risk population, which is well below 3.8 million gay men. French Minister of Social Affairs and Health Francois Brown said on Monday that only an estimated 6,000 people have been vaccinated in more than 100 vaccine centers in recent weeks in France. And in the UK, health officials last week ordered an additional 100,000 vaccine doses to keep pace with rising demand.

Last Saturday, the World Health Organization declared monkeypox a public health emergency of international concern, a classification assigned to the most threatening global disease outbreaks, after it initially abandoned it last month. More than two months after the first case of monkeypox was discovered in the United States in mid-May, public health officials in New York City on Thursday issued a declaration that the infectious disease posed an imminent public health threat, and officials in San Francisco declared the state. Emergency.

“What is interesting is that many of the scientists and clinicians who were trained during the AIDS epidemic or who were there at the beginning, like Tony Fauci, know this history, but the response to monkeypox has been alarmingly slow and chaotic,” said Greg Gonsalves, who joined Act Up. – The leading group that fought to fight AIDS – in 1990 and is now Professor of Epidemiology at the Yale School of Public Health. “As an individual, it’s like, three strokes, you’re out, man.” HIV, Covid and now monkeypox? How many times can you make the same mistakes over and over again? ”

Representatives of the National Institute of Allergy and Infectious Diseases, which Dr. Anthony Fauci has directed since 1984, and officials from the White House, where Fauci serves as the president’s chief medical advisor, did not immediately respond to NBC News’ requests for comment.

photos of men Waiting in long lines Outpatient clinics around the world for vaccination and technology Issues With online vaccine portals and reports accusing the US government of developing a “wait and see” response to the outbreak — said to be calling for shipments of vaccines only as cases surge in the past few weeks — activists have piled on concerns that the public health response to monkeypox is shaping up to be a repeat of its flawed strategy to combat the disease. AIDS.

People lined up outside the Ministry of Health &  A mental health clinic on June 23, 2022 in New York, where New York City provides vaccinations to residents potentially exposed to monkeypox.  (Tyfun Coskun/Anadolu Agency via Getty Images)

People queued outside the Department of Health and Mental Health Clinic on June 23, 2022 in New York, as New York City makes vaccines available to residents potentially exposed to monkeypox. (Tyfun Coskun/Anadolu Agency via Getty Images)

Although the virus began spreading in May, the United States did not order additional doses of the monkeypox vaccine to add to its stockpile until June. Regulators also didn’t finish checking a major facility in Denmark to manufacture monkeypox vaccines until July, leaving 1.1 million doses ready for distribution stranded in Europe.

“Just as during the AIDS pandemic, some governments seem to care less as long as monkeypox only affects men who have sex with men,” said Tatchell, who was removed from a London hospital that had run out of the monkeypox vaccine. last Sunday. “What other explanation could there be? Governments should have rolled out emergency vaccination programs for gay and bisexual men two or three weeks ago.”

Some seasoned AIDS activists argue that, as during the AIDS crisis, messages designed to combat monkeypox were not designed enough to reach the LGBTQ community.

Ron Goldberg, an early AIDS activist who joined Act Up in 1987, points to the “America Responds to AIDS” public service announcement campaign, launched by the government at the height of the crisis in the late 1980s. Several commercials featured heterosexual couples and featured messages including “AIDS is everyone’s problem.”

“At the time, they were so afraid to talk about gay sex, or anything like that, and they had to smear the message when they were trying to give some information,” Goldberg said. “If that’s happening within a particular population, you have to direct your messages to that particular population.”

Activists have largely praised the efforts of public health officials not to associate monkeypox directly with the LGBTQ community – as many believe with AIDS – and thus create stigma. However, some argue that repeated statements from public health officials that “anyone can get monkeypox” reflect AIDS messages that “anyone can get HIV” and also circumvent efforts to alert the population at greatest risk.

Research overwhelmingly indicates that the current outbreak of monkeypox is driven by an overwhelming majority of men who have sex with men. A study in the New England Journal of Medicine published last week found that of the 528 cases of monkeypox analyzed by researchers, 98% were found in men who identified as gay or bisexual. Another recent report from Britain’s Health Security Agency found that of the 699 cases of monkeypox for which information was available, 97% were gay, bisexual or other men who have sex with men.

Didier Lastride, who founded the first French chapter of Act Up in 1989, said: “The numbers are there. We shouldn’t be ashamed of this. … We are great people, old people, and we can afford it. Stigma happens either way.”

On Thursday, the World Health Organization recommended that gay and bisexual men limit the number of their sexual partners to protect themselves from monkeypox and contain its spread.

But after two years of pandemic isolation and big summer events, like last weekend’s annual Pines Party on Fire Island, some activists fear it will be difficult to persuade gay and bisexual men to curb their sexual behaviors.

“You want to be able to reach people in their twenties and thirties and say, ‘Look, this is not a joke. You’ve seen all the pictures. You’ve all had friends who had monkeypox.’ You don’t want that,” Gonçalves said.

More broadly, Lastrid has argued, the advent of pre-exposure prophylaxis, the HIV prophylaxis pill (also known as PrEP), along with scientific evidence over the past decade that HIV treatment can prevent transmission, has caused In the sleep of gay and bisexual men. When it comes to their sexual health.

The new generation has completely forgotten the story of AIDS. “I keep writing books on AIDS but no one reads them,” Lastrid said. “When that happens, they forget about the reactions we used to have because it was a matter of life and death.”

Regardless of the messages, with the release of a lackluster universal vaccine, activists fear the virus will become an infectious disease that the LGBTQ community will have to live with permanently, as it did with AIDS decades ago.

“A lot of people are saying we’re past the containment point, that we’ve really missed our chance,” Gonçalves said. “If true, this is very serious because this disease does not necessarily lead to death, but the enormous suffering and costs of all of this will put a burden on the many, many, many health systems and many, many communities that have already contracted the disease.”

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