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Being an Epidemiologist these days is not for the feint of heart, mostly because of inequality, and also collective amnesia. I suppose it’s inherent in any profession that seeks to designate oneself as an expert in attribution and causality when there are so many counterpoints and influencers pushing misinformation in pursuit of evading any culpability due to such associations is asking for drama.
Still consider the challenge for the World Health Organization (WHO) Director-General who had the integrity to declare a new resurgent epidemic of mpox in Central Africa on August 14th, 2024. Bless him. Certainly on the surface mpox doesn’t present the same broad risk spectrum that more traditional global health emergencies pose but mpox does share precedence with earlier infectious disease global threats–namely the Hepatitides and HIV/AIDS. All are diseases that spread through intimate and inconspicuous networks of transmission that are all too easy for the unaffected to ignore until they or a loved one are infected.
In fact, if we really look at mpox’s journey and the WHO’s warning closely we might actually start to appreciate how simply having such a broad gap between High Developed Countries (HDC) and Low Developed Countries (LDC) burdens the vulnerable in the LDCs to such a degree that anyone with a conscience who thinks on it long enough will ultimately accept how much more they benefit in the shared global arrangement, and thus how much more their responsibility must be to prevent more clads of mpox from circulating.
Granted conscience can only take us so far. Once you learn to internalize the differential impact of mpox across geopolitical lines and really empathize with the families now dying from it in DRC and Uganda, Kenya, and many other countries in the region then suddenly what once was just a controversial international public health emergency instead starts to look more like a match lit in the United States which we just toss over the Atlantic Ocean into a pile of dynamite in Central Africa.
Which gets this Epi thinking. What if there was a fiduciary obligation for every 2022 mpox case in the United States that transmuted into 2024 mpox death in Kenya? Yeah that would be a lot of work, so instead how about every US municipality without a legit mpox public health education, surveillance, and vaccination operation who allowed an mpox case to slip through cuts the WHO a check for a million dollars per case. The WHO could then create a fund that families in more afflicted climes could draw down from to cover the loss of the caregiver to a family of five children already struggling to survive with Anemia, Malaria, Dengue, Ebola, MDRTB, when the mpox infection was punted to them from the States.
Now that would be a controversial mpox program. Sure as mpox elimination programs go I assume it wouldn’t be as popular in HDCs as it might in LDCs, but ultimately who should the Epidemiologist be beholden to? The sickest of the sick or the slickest of the slick.