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On the 14th of August, 2024, the World Health Organization (WHO) declared MPox a Public Health Emergency of International Concern - just a day after the Africa CDC had issued a Public Health Emergency of Continental Security, following a noticeable increase in infections and deaths on the continent. Several countries around the world began monitoring the spread of the disease. While some countries raised the alarm and started asking questions about their preparedness, others considered it a less significant threat – with some commentators noticing how the talk and concern about MPox is skewed towards the wealthy countries (Adetifa et al 2023).

Health care workers at an mpox treatment center near Goma, Congo, on Aug. 17, 2024 © Guerchom Ndebo / AFP via Getty Images

Soon after, there arose a perhaps natural proclivity towards comparison between COVID-19 and MPox. Headlines such as “could MPox be the new COVID-19?”  started to appear on mainstream media. The WHO and many news outlets soon assured that MPox was “not the new COVID-19”. The initial alarm has been supplanted by less provocative headlines, which stress the danger of the disease, but also its low-risk (for instance herehere, and here). This “alarm-but-no-cause-for-alarm” attitude upholds the very tension between willingness to take action and a degree of restraint to preserve fundamental freedoms and avoid public backlash. This tension, of course, characterized the recent COVID-19 experience. It is only natural, therefore, to ask whether that experience can teach us anything about how to handle this tension.

The shadow of history often operates centrally during any narrative of outbreaks. We are told that we have to learn from history, so as not to repeat its mistakes. But learning lessons is very difficult, for several reasons.

1. Many pasts, intersecting pasts

First, one must complicate the rather simplistic notion of ‘learning from history’ and recognise, at the outset, that histories remain plural. What one learns–if at all–depends on which past is being invoked and studied. With MPox, history seems to be deployed in two diverging strains. The first strain of history is a history of negligence and a consequent call for pro-action. This history highlights how MPox sporadically appeared in different parts of the world but never really assumed devastating proportions. However, it remained endemic to certain parts of  Africa, where it became highly infectious and a persistent threat, with the last outbreak in 2022. This persistence has been largely attributed to the historical neglect of the  disease (Adetifa et al 2023). It is precisely building on this history that the WHO mentions the need for a co-ordinated response for MPox globally, to prevent this history of negligence in Africa “from repeating itself” at a global level. Ifefayo Adetifa and colleagues have framed it as “a problem for Africa, a problem for the world” (Adetifa et al 2023), suggesting that an event in any part of the world and our (in-)action as a response will likely have consequences on the rest of us.  The call, therefore, is for collective cooperation. The lesson from this history is caution; its guiding principle is the need to tackle an issue before it becomes worse.

The other strain is the history of public backlash as a result of COVID-19 policies. This is a history of public ire, of conflict, dissonance, polarisation, and of the consequent undermining of trust in public health officials. What does this history teach us? The 'lesson learnt' here is, perhaps, the need for a different kind of caution, a more guarded approach, a degree of restraint before declaring or deploying mass measures against outbreaks.

Thus, in invoking the need for ‘learning from history’, one is faced with the fact that the ‘learning’ from both these histories seems to be the exercise of caution. However, these two histories seem to intersect and work counterproductively against one another.

 

Read the full story on TORCH website.