Opinion – Atila Iamarino: Smallpox: a new virus, with old mistakes

HIV has reached many more people through a series of human errors. The virus has been circulating among humans since the early 20th century, with the first cases traced back to the Democratic Republic of Congo region. But it was first recognized in the gay population of Europe and the US in the early 1980s, when young people began to suffer from atypical infections, with the destruction of their immune system.

At a time when antibiotics treated many sexually transmitted infections and condoms were seen more as a contraceptive method, gay men had more unprotected relationships with new partners, which favored the transmission of HIV initially between them.

This relationship appears in the first name given to the disease caused by the virus: GRID, or Gay-Related Immune Deficiency, the immunodeficiency related to gays. In Brazil, it was even called the gay plague. This contributed to the virus spreading among gay men, who were further stigmatized rather than welcomed, and among heterosexuals, who did not feel vulnerable to a virus that would only affect gay men, rather than treating it as something that could be transmitted by any unprotected contact. Fortunately, Brazil adopted strategies that allowed us to be a global example of controlling and combating HIV.

Now, with the new smallpox, or monkeypox, or monkeypox, science has many advances that allow us to avoid the same problems. The monkeypox virus did not need to circulate for more than a decade before it was detected. We have vaccines and surveillance to detect their cases in Brazil, which now exceed 2,200. And we have our history of action against HIV to show what to do.

But several problems recur. Starting with the name of the disease, which took a while to be officially updated. Fiocruz recommends the term monkeypox, to reduce the stigma it can cause. While primatologists refer to it as new smallpox, to recognize that it has nothing to do with monkeys.

Its transmission outside Africa, concentrated in men who have sex with men, needs to be recognized to prioritize care, partner reduction and even vaccination, while vaccine doses still take time. At the same time, its transmission is independent of sexual orientation and contact with infected skin or body fluids can happen even without intimate contact.

We already have cases among children and the virus can still circulate among many more people. And hospital or even prison settings are particularly worrisome.

Between testing, contact tracing and education campaigns, we know what to do in the country at this crucial time, until we have enough vaccines. But we still haven’t declared a health emergency and it takes time to buy vaccines. If we still don’t see federal action against Covid, which never had a coordinated plan even though it killed almost 700 thousand people in Brazil, we will see even less against an infection with this context of transmission in 2022.

And we’re not the only ones late. In the midst of the biggest pandemic of this generation and paying dearly for it, we don’t mobilize to avoid the next ones. The HIV situation began to reverse when countries recognized that they needed to act even on the African continent, following the Brazilian program for the purchase and free distribution of antivirals.

With the new smallpox, we repeat the same mistake. The African continent, where cases have been ignored for decades, where the virus still circulates between animals and humans, is still the last region without a single dose of vaccine.