Monkeypox response: Rationality must prevail

What took economists a big nudge from their behavioural colleagues to accept, that the most rational and elegant of curves drawn by theory frequently get warped by real-world impulses, epidemiologists who watched HIV-AIDS unfold have long known. Four decades ago, an ‘infodemic’ of falsehood coupled with sexual prejudice hobbled our fight against that deadly viral outbreak at its most vital stage, its very start, bending its trend the wrong way. With monkeypox now a global concern, as declared by the World Health Organization (WHO), we cannot afford a failure redux. As a pathogen, the bug that causes this illness is not nearly as catchy as the covid virus, far less deadly than HIV, and its effect is more like a mild version of smallpox. None of these threats is alike, except that anyone can catch it. Covid contrasts can be pinned on a recency bias, smallpox has overlaps of symptoms and vaccines, but the way monkeypox recalls early AIDS is no less worthy of top-level attention. This it does in two ways: too little known by way of what its science says, and too close an apparent link of cases with gay sexuality. In an age of online infodemics, a sordid slice of 80s history must not get to repeat, be it as a tragedy or farce.

The scandal here is clear. Monkeypox is an affliction that west and central Africa have lived with for half a century, but it has taken the bug’s big leap north for its study to start being globally funded. It’s odd that the world is yet to figure out some of its basics. This testifies to a lopsided health agenda and the neglect of a disease that wasn’t claiming the lives of famous film stars. We may need to dust off our smallpox manual for health safety, while we grapple with strands of DNA as much as its impact on social media. “Some cases have been identified through sexual health clinics in communities of gay, bisexual and other men who have sex with men,” says the WTO advisory for a group with a distinct case bulge, as infection samples have reportedly shown. “It is important to note that the risk of monkeypox is not limited to men who have sex with men,” it adds, pointing out that any close contact with an infectious person is risky. Intimacy, especially. This aspect of its contagion, sex, could cloud the path ahead. In the case of AIDS, the microscopic fact of it being an equal-opportunity killer was up against a social spasm of homophobia. The link’s stigma combined with fear to worsen gay otherization, even as sex-talk taboos cast a pall of silence in polite circles, making space for myths to multiply in others. Low acceptance of an alternate orientation, despite it being just as natural, fed dismal lies that fanned the virus along its upward path.

This time, we must not let scientific facts get garbled by irrationality. As the WHO said, we must not let any stigma develop. Nor the perception that this eruption will exhaust itself within a sexual minority. The Indian Council of Medical Research has done well to move on vaccine defence, thus signalling our common exposure. We must keep the virus in public focus and not let irrational biases or sexual bigotry suffuse chats and warp attitudes. This goal calls for a clear and scientific command of the monkeypox narrative at every level. Social, too. What is not “against the order of nature” mustn’t be held as such. And for the sake of our own collective health, inclusive views of sexuality literally need to be common sense.