Over the last three months, cases of monkeypox have been reported from countries where the disease is not endemic, and continue to be reported in several endemic countries. Since then, the virus has continued to spread, prompting the World Health Organisation to declare the monkeypox outbreak a public health emergency of international concern.

To make the necessary coordinated international response truly effective, it will be important to drive lessons from the past, from the AIDS crisis to the Covid-19 pandemic: stigma directed at certain groups of people undermines a truly comprehensive response to outbreaks, exacerbates hatred against already marginalised communities, and further hinders their access to health services.

This public health emergency is already deeply affecting parts of our communities. According to the latest WHO data, most confirmed cases were identified among men who have sex with men. While we need to ensure that responses to this health emergency take into consideration the population most at risk, they cannot fuel further marginalisation and stigma. As stated by the WHO Director General: “Stigma and discrimination can be as dangerous as any virus."

Therefore, ILGA World calls on everyone to get the facts on monkeypox right, reject stigma and discriminatory language, and ensure equal access to vaccines and healthcare.

Stigma and discrimination can be as dangerous as any virus. I am calling on civil society organizations, including those with experience in working with people living with HIV, to work with us to fight stigma and discrimination associated with this #monkeypox outbreak.

— Tedros Adhanom Ghebreyesus (@DrTedros) July 23, 2022

Get the facts right

The monkeypox virus is transmitted from one person to another by close contact with lesions, body fluids, respiratory droplets, and contaminated materials such as bedding. Although it can also spread during close skin-to-skin contact during sex, monkeypox is not a sexually transmitted disease (STI), and it is not linked to a person’s sexual orientation.  

Anyone who has close contact with someone who is infectious is at risk of contracting monkeypox.  However, many cases have so far been identified among gay, bisexual, and other men who have sex with men, and trans and gender-diverse people may also be more vulnerable in the context of the current outbreak. The risk of monkeypox is not limited to these communities, but they are, according to current data, most-at-risk in the current outbreak.

While responses to this health emergency need to take into consideration the situation of marginalisation already affecting our communities, it is fundamental that measures taken do not fuel stigma and discrimination against us, and that responses are grounded in a human rights-based approach.

Instead of pointing at convenient scapegoats in a time of public health emergency, States and health officials should focus on addressing a situation that is already affecting communities as a whole.  As noted by the WHO Europe regional director, “It’s clear that cases in other population groups (beyond MSM), including women and children, are increasing. Close-contact sexual transmission is the key mode of spread, but cases are being detected through household transmission episodes, and sometimes with no clear exposure history at all.”
 

Read more from the World Health Organization:
key facts - symptoms - Q&A -
public health advice for gay, bisexual and other men who have sex with men

Reject stigma and discriminatory language 

Since the start of the current outbreak, UNAIDS has rightly spoken out against language and images that reinforce homophobic and racist stereotypes in addressing the monkeypox emergency. 

Rather than scapegoating key populations, as well as the African population, everyone should stick to the available evidence rather than trying to identify supposedly 'guilty' individuals based on convenient stereotypes.

As we have seen time and time again, from the AIDS crisis to  Covid-19 associating a pandemic  with certain groups of people alone undermines a fully comprehensive response to outbreaks, exacerbates hatred against already marginalised communities, and further hinders their access to health services.

Avoiding the spread of misinformation and rejecting stigma will be crucial to rapidly address what is now a public health emergency of international concern, and to address it effectively before situations escalate further. 

Ensure equal access to vaccines and healthcare

As Monkeypox cases reach over 18,000 in 78 countries, the WHO recommends targeted vaccination for those exposed to someone infected and those at high risk of exposure.

However, the WHO Director-General explained that currently there are challenges concerning the availability of vaccines, and has urged countries with available vaccines to share them with countries that don’t. 

To ensure an equitable access, however, more will need to be done: to have potential patients coming forward, all barriers to testing, medical attention or vaccination will need to be removed. Stigma and judgement are obstacles too big to overcome for patients along their pathway to health. Lessons from past emergencies must not be forgotten.