Month: May 2022

The WHO European Region remains at the epicentre of the largest and most geographically widespread monkeypox outbreak ever reported outside of endemic areas in western and central Africa. The learning curve has been steep over the past 2 weeks. We now have a critical opportunity to act quickly, together, to rapidly investigate and control this fast-evolving situation.

Today, I would like to outline what we have seen and learned, and what still needs to be understood, and to set us on the right path in tackling this challenge.

What have we seen and learned?

Even as new patients present every day, investigations into past cases show that the outbreak in our region was certainly underway as early as mid-April. Strong surveillance and diagnostic systems in several European countries, along with swift cross-border information-sharing mechanisms with the support of WHO and other partners, are to be commended for the outbreak coming to light.

Based on the case reports to date, this outbreak is currently being transmitted through social networks connected largely through sexual activity, primarily involving men who have sex with men. Many -- but not all cases -- report fleeting and/or multiple sexual partners, sometimes associated with large events or parties.

We must remember, however, as we have seen from previous outbreaks, that monkeypox is caused by a virus that can infect anyone and is not intrinsically associated with any specific group of people. The gay and bisexual communities have high awareness and rapid health-seeking behaviour when it comes to their and their communities' sexual health. Indeed, we should applaud them for their early presentation to health-care services.

Rapid, amplified transmission has occurred in the context of the recent lifting of pandemic restrictions on international travel and events. The potential for further transmission in Europe and elsewhere over the summer is high. Monkeypox has already spread against the backdrop of several mass gatherings in the Region. Over the coming months, many of the dozens of festivals and large parties planned provide further contexts where amplification may occur. But they also provide powerful opportunities to engage with young, sexually active and globally mobile persons to raise awareness and strengthen individual and community protection.

We do not yet know whether the monkeypox virus can also spread from one person to another through semen or vaginal fluids, nor whether the virus could persist in these bodily fluids for longer periods of time.

We do know that most people who get monkeypox will have a mild and self-limiting but unpleasant and potentially painful disease that may last up to several weeks. We do not yet know what health impact there will be in individuals who can have severe outcomes from monkeypox, particularly young children, pregnant women and people who are immune-compromised.

What does an effective response in Europe look like?

As of now, an effective response to monkeypox will not require the same extensive population measures as we needed for COVID-19 because the virus does not spread in the same way. But -- and this is important -- we do not yet know if we will be able to contain its spread completely. For that, we need a significant and urgent reduction in exposures through clear communication, community-led action, case isolation during the infectious period, and effective contact tracing and monitoring.

Monkeypox has not been at the forefront of research and development in the field of infectious diseases. As such, tools to manage it -- including readily available diagnostics, vaccines and therapeutics -- are not likely to be immediately or widely accessible to countries. While one vaccine (MVA-BN) and one specific treatment (tecovirimat) were approved for monkeypox in 2019 and 2022 respectively, these countermeasures are not yet widely available.

Our goal is to contain this outbreak by stopping human-to-human transmission to the maximum extent possible.

We will interrupt transmission if we act now in:

• Actively engaging community groups and leaders and civil society organizations to increase awareness and share information on how people can reduce their risk of exposure, including by reducing the number of sexual partners they have.

• Strongly encouraging people -- including young people regardless of gender and sexual orientation or activity -- to increase their awareness of monkeypox and know what to do if they think they may have been exposed to the disease or have signs consistent with it.

• Supporting organizers and participating communities in upcoming mass gatherings across Europe to leverage these events to share accurate, practical and targeted information with participants.

• Equipping health facilities and public health teams with the knowledge and diagnostic capacities they need to rapidly identify, investigate and confirm cases.

• Ensuring monkeypox patients are informed about their need to isolate for the infectious period of their illness, refrain from sexual and other close contact with others, and are supported during their isolation.

• Swiftly tracing all contacts of cases and monitoring their absence of any relevant illness over 21 days. While the quarantining of contacts may not be necessary, twice-daily temperature checks and self-monitoring are critical.

• Using the currently available medical countermeasures fairly and equitably, based on level of risk, availability and the appropriateness of the intervention. We cannot allow ugly competition for constrained resources to mirror the early days of the COVID-19 pandemic.

By achieving these measures, we can help:

• demystify monkeypox, which is not a well-known disease in Europe, countering misinformation already being manifested across social media and other platforms;

• accelerate regional, country and community-led action to stop spread;

• provide equitably available diagnostics and medical countermeasures such as vaccines and antivirals to affected communities and other relevant constituencies;

• ensure that no one is stigmatized, or it will damage our collective response.

We have learned a lot from our COVID-19 experience, in terms of cross-country collaboration and information-sharing mechanisms, heightened surveillance, and risk communication as a public health intervention, including at the community level. We have also seen how misinformation amplified online and through other sources can lead to negative public health outcomes.

All of these lessons can and should better inform our actions going forward. Let us therefore bring government, civil society and health partners together to tackle this public health challenge decisively and effectively, guided at all times by science and medicine, and imbued with respect and compassion.

Source: World Health Organization

An International Atomic Energy Agency (IAEA) mission found that Zimbabwe has made considerable improvements in its national legal and regulatory infrastructure for nuclear and radiation safety by drafting a new law that addresses the requirements of IAEA international safety standards. The team of experts said that enhanced efforts to develop education and training in radiation protection and safety will further build national capacities.

The Integrated Regulatory Review Service (IRRS) team reviewed progress in Zimbabwe’s implementation of recommendations and suggestions made during an initial IRRS mission in 2014. The six day follow-up mission, which ended on 28 May, was conducted at the request of the Government of Zimbabwe and hosted by the Radiation Protection Authority of Zimbabwe (RPAZ).

The team found that Zimbabwe has successfully implemented many recommended actions from the mission eight years ago, highlighting in particular the draft Radiation Protection Amendment Bill which is scheduled to be passed in 2023, and the draft National Nuclear and Radiological Emergency Plan that has been developed.

IRRS missions are designed to strengthen the effectiveness of the national nuclear and radiation safety regulatory infrastructure, based on IAEA safety standards and international good practices, while recognizing the responsibility of each country to ensure nuclear and radiation safety.

The mission reviewed the regulatory framework for all facilities and activities using radiation in Zimbabwe. Zimbabwe, which in 2021 joined four multilateral treaties in nuclear safety and security, uses radiation sources in medical and industrial applications.

“Zimbabwe is only the second African nation, after Cameroon, to invite a follow-up IRRS mission, and they have shown dedication to meet the findings from 2014,” said Peter Johnston, Director of the IAEA's Division of Radiation, Transport and Waste Safety, at the exit meeting of the mission. “The staff of RPAZ provided the fullest practicable assistance and demonstrated extensive openness and transparency”.

The IRRS team, comprised of six senior regulatory experts from Kenya, South Africa, Sweden, Qatar, and the United States, and two IAEA staff members, conducted a series of interviews and discussions with the staff of RPAZ and reviewed the reference material that they provided in advance.

In addition to the new draft law and plan, the team welcomed the following steps taken by Zimbabwe:

Ratification of international instruments related to nuclear safety and radiological protection.

Reorganization of RPAZ to ensure an effective separation of regulatory functions from the provision of technical services.

The development of RPAZ guidance documents on the core functions of the regulatory body.

Construction of a new radioactive waste management facility, planned to be licensed at the end of 2022.

“Zimbabwe is heading in the right direction and the new Bill demonstrates the Government’s commitment to safety,” said Patricia K Holahan, Special Assistant to the U.S. Nuclear Regulatory Commission and Team Leader for the mission. “It is important now that Zimbabwe implements the Bill with new regulations to ensure that the RPAZ has the appropriate authority, requirements and resources to enforce the law. In addition, the new radioactive waste facility allows for safe management of radioactive waste and they have made significant progress on ratification of international conventions.”

The review team recommended that Zimbabwe continue its efforts to strengthen education and training in radiation protection and safety. The team also recommended that Zimbabwe develops:

A national policy and strategy for radiation safety.

Regulations for the transportation of radioactive material and for emergency preparedness and response.

Cooperation with other national authorities involved in the transport of radioactive materials.

Justice Chipuru, Chief Executive Officer of RPAZ, said “Zimbabwe is committed to the continual improvement of the regulatory infrastructure and is grateful for the assistance granted by the Agency. The regulatory body has adopted a policy of periodic peer reviews at least once every five years going forward”.

The final mission report will be provided to the Government in about three months. The Government plans to make the report public.

Source: International Atomic Energy Agency

After seven decades on the throne, Queen Elizabeth II is widely viewed in the U.K. as a rock in turbulent times. But in Britain's former colonies, many see her as an anchor to an imperial past whose damage still lingers.

So while the U.K. is celebrating the queen’s Platinum Jubilee — 70 years on the throne — with pageantry and parties, some in the Commonwealth are using the occasion to push for a formal break with the monarchy and the colonial history it represents.

“When I think about the queen, I think about a sweet old lady,” said Jamaican academic Rosalea Hamilton, who campaigns for her country to become a republic. “It’s not about her. It’s about her family’s wealth, built on the backs of our ancestors. We’re grappling with the legacies of a past that has been very painful.”

The empire that Elizabeth was born into is long gone, but she still reigns far beyond Britain’s shores. She is head of state in 14 other nations, including Canada, Australia, Papua New Guinea and the Bahamas. Until recently it was 15 — Barbados cut ties with the monarchy in November, and several other Caribbean countries, including Jamaica, say they plan to follow suit.

Britain’s jubilee celebrations, which climax over a four-day holiday weekend starting Thursday, aim to recognize the diversity of the U.K. and the Commonwealth. A huge jubilee pageant through central London on Sunday will feature Caribbean Carnival performers and Bollywood dancers.

But Britain’s image of itself as a welcoming and diverse society has been battered by the revelation that hundreds, and maybe thousands, of people from the Caribbean who had lived legally in the U.K. for decades were denied housing, jobs or medical treatment — and in some cases deported — because they didn’t have the paperwork to prove their status.

The British government has apologized and agreed to pay compensation, but the Windrush scandal has caused deep anger, both in the U.K. and in the Caribbean.

A jubilee-year trip to Belize, Jamaica and the Bahamas in March by the queen’s grandson Prince William and his wife Kate, which was intended to strengthen ties, appears to have had the opposite effect. Images of the couple shaking hands with children through a chain-link fence and riding in an open-topped Land Rover in a military parade stirred echoes of colonialism for many.

Cynthia Barrow-Giles, professor of political science at the University of the West Indies, said the British “seem to be very blind to the visceral sort of reactions” that royal visits elicit in the Caribbean.

Protesters in Jamaica demanded Britain pay reparations for slavery, and Prime Minister Andrew Holness politely told William that the country was “moving on,” a signal that it planned to become a republic. The next month, Antigua and Barbuda Prime Minister Gaston Browne told the queen’s son Prince Edward that his country, too, would one day remove the queen as head of state.

William acknowledged the strength of feeling and said the future “is for the people to decide upon.”

“We support with pride and respect your decisions about your future,” he said in the Bahamas. “Relationships evolve. Friendship endures.”

When then Princess Elizabeth became queen on the death of her father King George VI 1952, she was in Kenya. The East African country became independent in 1963 after years of violent struggle between a liberation movement and colonial troops. In 2013, the British government apologized for the torture of thousands of Kenyans during the 1950s “Mau Mau” uprising and paid millions in an out-of-court settlement.

Memories of the empire are still raw for many Kenyans.

“From the start, her reign would be indelibly stained by the brutality of the empire she presided over and that accompanied its demise,” said Patrick Gathara, a Kenyan cartoonist, writer and commentator.

“To this day, she has never publicly admitted, let alone apologized, for the oppression, torture, dehumanization and dispossession visited upon people in the colony of Kenya before and after she acceded to the throne.”

U.K. officials hope countries that become republics will remain in the Commonwealth, the 54-nation organization made up largely of former British colonies, which has the queen as its ceremonial head.

The queen’s strong personal commitment to the Commonwealth has played a big role in uniting a diverse group whose members range from vast India to tiny Tuvalu. But the organization, which aims to champion democracy, good governance and human rights, faces an uncertain future.

As Commonwealth heads of government prepare to meet in Kigali, Rwanda, this month for a summit delayed by the coronavirus pandemic, some question whether the organization can continue once the queen’s eldest son, Prince Charles, succeeds her.

“Many of the more uncomfortable histories of the British Empire and the British Commonwealth are sort of waiting in the wings for as soon as Elizabeth II is gone,” royal historian Ed Owens said. “So it’s a difficult legacy that she is handing over to the next generation.”

The crisis in the Commonwealth reflects Britain’s declining global clout.

Zimbabwe was suspended from the Commonwealth under its authoritarian late President Robert Mugabe, and is currently seeking readmission. But many in its capital of Harare have expressed indifference to the queen’s jubilee, as Britain’s once-strong influence wanes and countries such as China and Russia enjoy closer relations with the former British colony.

“She is becoming irrelevant here,” social activist Peter Nyapedwa said. “We know about [Chinese President] Xi [Jinping] or [Russian President Vladimir] Putin, not the queen.”

Sue Onslow, director of the Institute of Commonwealth Studies at the University of London, said the queen has been the “invisible glue” holding the Commonwealth together.

But she says the organization has proven remarkably resilient and and shouldn't be written off. The Commonwealth played a major role in galvanizing opposition to apartheid in the 1980s, and could do the same over climate change, which poses an existential threat to its low-lying island members.

“The Commonwealth has shown a remarkable ability to reinvent itself and contrive solutions at times of crisis, almost as if it's jumping into a telephone box and coming out under different guise," she said. “Whether it will do it now is an open question.”

Source: Voice of America