The monkeypox outbreak must amplify hidden voices in the global discourse

Tulio d Oliveira's Comment¹ on the global inattention to infectious disease science done in Africa is timely, as the largest outbreak of monkeypox outside of Africa continues.² As of June 15, 2022, 2103 laboratory-confirmed cases of monkeypox have been reported to WHO from 42 countries. The unexpected, unprecedented, and unusual nature of this outbreak in Europe and the Americas has spurred scientific, political, and media attention. Importantly, monkeypox has been known to cause human disease for over 50 years and is endemic in at least ten countries in west and central Africa with over a thousand incidences reported in the Democratic Republic of the Congo in the first 3 months of 2022 alone.³ Specialists in these countries have decades of experience managing such outbreaks, often with little support, and have repeatedly warned of the potential for monkeypox's globalisation and the need for affordable tools and improved surveillance.

Despite the vast expertise of these specialists, their voices are notably absent from the current discourse and many have struggled for years to raise awareness, publish their findings, or attract funding to study this disease.⁴ As with the COVID-19 pandemic, monkeypox highlights inequities in access to vaccines, diagnostics, and treatments. High-resource nations, WHO, other global stakeholders, and government actors must meaningfully recognise the vast lived experience and repeated warnings of public health specialists in Africa. Equity in the global dialogue on pathogens with epidemic potential requires a priority seat at the table for those who have the most experience, despite them being pushed into the shadows for decades.

This online publication has been corrected. The corrected version first appeared at thelancet.com on July 8, 2022

For WHO's monkeypox outbreak situation update see https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON393