with leadership hopefuls are falling over themselves to make and found an awful the almost wrong. i'm to see economic is well underway. over we share the content is of my more than 200000000000 pounds worth of funding, spending commitment to hon. you get the sig that's more than the annual bunch of the n h s. splunk on the page of the sunday papers without a word on how it would be paid. fantasy will soon meet reality galloping inflation, economic stagnation and a major war in europe was just a few problems from the prime minister's intro. it may be scorching now, but for whoever wins, things will only get hotter, will reach helen's al serra london ah

says al jazeera, these, you top stories of private funerals been held for japan's former prime minister sion. so abbe, crowds of people lined the streets to pay their final respects. he was assassinated while campaigning at an election rally on friday. tony chang has more from outside the temple and take care where the funeral took place. a large crowd of people waiting outside, wanting to pay their respects, but also very silently with no spontaneous shows agree or emotion. i think, to a certain extent, people here are still very strong. this has happened so quickly to a prime minister that although he stepped down by the time he was assassinated, still room very large on the political stage and had had such a profound impact on japan. for the past inter lanka, basil roger packs of the brother of the president has been prevented from leaving the country as in apple in colombo, comes his anger against countries. leaders is

a boiling point to speak of parliament says a new president will be chosen next week. a protest is occupying the official residents refusing to leave until got to buy a bunch of packs of steps down. the small pacific allan nation, a carry boss, has withdrawn from a crucial fiji based regional blog, says micronesia countries have been sidelined in the leadership of the pacific island forum. ukrainian forces say they've destroyed a russian military ammunition deputy the castle region ne, by residential buildings have also been damaged. keith has called on civilians to leave parts of the region. it is the 1st anniversary of nation wide anti government protest in cuba, demanding social and economic reforms. he says the u. s. was behind last year's demonstration of human rights watch. reports has found the government committed human rights violations in response to the massive purchase. the british olympic champion mo fora, has revealed, he was

a victim of child trafficking. he says he was smuggled into the u. k, from djibouti as a 9 year old and forced to work as a domestic 7th. are says he was given his name by women who took him from his family and she had lives. the stream is next. we don't simply focus on the pelican of the conflict. it's the consequence of board. the human suffering that we report time is one of the most serious about the violent and recent here we brave bullet bomb because we give voice to those demanding freedom the rule of law. and we always include the views from all sites with welcome to the stream, i'm at sabot dean. and today we look at monkey pox. it's spreading faster than ever before. and while it's not as deadly as coven 19 health experts warned that without a proactive approach to testing vaccinations and building public awareness,

the disease could very well become endemic in many more countries. if you have a question about monkey pox or you want to jump into our youtube chat, you too can be part of today's conversation. ah, new cases of monkey pox continue to spread to countries where the virus is typically not seen. thousands of cases have been found in at least $57.00 countries already and mainly among men who are gay and bisexual. here with us to talk about the global outbreak, we have benjamin ryan, a science journalist, based in new york city in geneva, dr. rosamond louis of the world health organization and then you owned a cameroon. yeah, boom. a micro biology professor and regional representative for api song. that's the research arm of doctors without borders. thank you all for being with us just to kick things off. i was hoping to just make you listen to

a video comment that we here at the stream received from a science journalist based in san francisco. her name is liz. hi, lehman take, listen. we still have a lot to learn about monkey pox, but right now it does appear to be spreading among primarily among gay, bisexual and other management of sex with men in the united states and other countries where it hasn't been endemic. but we do know that it transmits from close personal contact, including sexual contact, which could include a skin to skin contact, kissing contact with clothes or bedding that have been in touch with the source of someone with monkey pox. so anyone could potentially get it. and what we need now is more testing and more widespread testing. so we can see where this epidemic going because that's the only way we're going to be able to contain it. so awesome, and you heard her say we need more testing and if i'm not mistaken, i understand it's primarily transmitted through skin to skin contact. what do we need to know about monkey pox in your mind?

well, monkey pots is a disease. it's that is related to what used to be small clocks which was eradicated in 1980. right. so we spent 40 years with a learning about monkey pox as it has arisen in the african setting where it was 1st discovered some time back. and so it's not a new disease, that's one important feature. it's not, you know, but it is something that has been emerging over a long period of time. and so what we're seeing now is a completely different outbreak. it's not been seen in this way before. it's manifesting in a completely new way, and i appreciate you bringing that up. i see benjamin nodding when you say it's manifesting in a completely new way, anecdotally, i've heard what those ways are. i'm curious, benjamin, for our audience. why is it spreading to new countries in your mind? and what do you think rosamond was referring to? what, what shocks you most about how it is spreading? i think what i could certainly comment on is that what we're seeing from the data is that this is primarily spreading amongst a sexual networks of men,

o sex with men. it seems to be what's happened is it made its way into western europe about 2 months ago and into groups of gatherings of gay man parties, group sex activities. a lot of these guys have done a lot of traveling, and they engage in multiple sex with multiple partners in short periods of time, which is a great way for pathogen to transmit. so it's hard to know without a lot more testing, but it's the day that we do see suggest that 95 percent or more of the cases may be in masters of men. and i've heard a lot of public health officers kind of down playing that they'll lead with this concept of anyone can get a monkey pox. but i feel it a bit simplistic because it's not necessarily a binary question, which is the most important question. but who is the most likely to encounter this virus? and who is the most likely to then contract it and why? and, and boom, when you hear benjamin explain this outbreak, this global outbreak which is unprecedented. what comes to mind based on your

experience with this in africa, particularly in cameroon. a yeah, to forgive me with forget me up. i actually can go if you have or won't. how get thank you. so what is quite interesting grief that more people are great, keeps remaining us how we are interconnected and how we interdependent within was mentioned, duckies on, or disease that have been indian making many african countries in kangaroo, dfcs, cow. and now all of the blue you can see happening all over the world. so it remind us how we must make sure that we control or do emergency even when we don't think that they will join the western countries. we now yeah, and you know, when we talk about that, it's kind of unfortunate. i mean, you know, there's a lot of stigma and concerns around how to talk about this with the l g b t q plus community. but also, it's

a bit disappointing that it's only now getting attention that it spread in europe as we heard, and amongst western countries. i'm curious though, in the mean time, you know, whether to call it a pandemic or not rosamond, i know there have been people like eric fy building on twitter. he wrote an article for the washington post saying it's time for the global public health community to recognize a growing reality that it is. in fact that i entered jack. yes, italy's ends of end and i is benjamin area. bagel. king is a doomsday profit. who leverage is his guerria to gain followers on twitter, and i don't think he is any one that we should listen to about this topic. okay, fair enough. i appreciate you. i appreciate you jumping in there and he knows very well that i feel that way of. no, no, no. i help you asking me any minute. i know i'm happy to answer the question all the same rosa road. i answer the question but, but let me add just one last thing. for example, he's saying this comparison right over 30 years, we've only tracked 2000 monkey pox. place that case is globally in total. in the last 2 months, in contrast, we have tracked 7000 new cases now but provide some context either. let's,

let's start with rosamond. i mean, on the face of it, if you don't know much about either of these things, that's quite alarming is a true. okay, so there's a number of the components in his statement there. so the 2nd part is correct. today's figures are over 7000. well, $7107.00 confirmed cases in 60 countries since the beginning of may essentially i'm so the case smith started before that, but they were beginning to be reported to the world health organization at the beginning of may. the 1st part of this case of a statement is not entirely correct. um, because there are cases that have been reported and, and yep, we'll talk about these, i'm sure, but, and tens of thousands of cases reported in places like the democratic republic of the congo in central africa. but of course, they don't have access to testing. so as liz mentioned, access to testing is, is critical in responding to this outbreak. but it has been critical and responding

to monkey pox for decades. and, and so though, met the some countries can only report suspected cases. they don't have the ability to report confirmed cases and, and that is a critical feature and distinguishing between, you know, a, what do we really know about this? so there are a number of, of, you know, features around monkey pox which there, there's a classic description which you've all heard about, the type of the rash, the way progresses. the predominant syndrome that begins with fever that begins with a of course, swollen lymph nodes, is very classic. that was what was used 40 years ago to distinguish monkey box from smallpox. and so these are the classic descriptions of the disease. and we're, we're, we are hearing some deviation from that today i, but there's always been a wide range of clinical manifestation from subclinical infection, which means people could be exposed and mount her antibody response, but never have symptoms to very severe illness and death. so it's not only a mile disease, it's a disease that can affect it can affect many,

it can affect any one. the way it transmits is primarily on face to face skin to skin. but we are, you know, we're not ruling out other possibilities and we have a lot to learn. we all a lot to learn about this about this outbreak. i, 1st of all, i think words are really super important, right? so pandemic is one of those words that everybody uses it differently. and what does it mean? and, and, and in, in international public health. the word pandemic is used specifically in the context of pandemic influenza, which has been known for a long time. you've all heard in the last few years about waves of, of influenza pandemic. it's not something that is actually used to trigger global response. okay. the world health organization under the international health regulations, has something called a public health emergency of international concern, which was called free book, which was called physique, and which was called for sars, which was called for. so a coven, 19 so. so essentially, i mean the,

i understand and appreciate that it's important, you know, how we talk about this. ah, with that in mind, i'm, i do wonder benjamin, you've interviewed several people from the gay community in particular, including a man in london who had quite a harrowing case. we've seen online as people are kind of describing their journey . either worried about having it or eventually that getting diagnosed. there's been a lot of miss diagnosis. what can you share with us about what they've, they've told you? well, some of the day they were seeing as it perhaps up to maybe about 10 percent of people who contract monkey pox in his global outbreak are being hospitalized. now, some of that to beat, to treat severe pain or infections of legions. and some of that may be if they can't isolate otherwise, it's only people that have talked to have experienced this pain. it's pretty uncanny what they're going through. and this could be a bias of the kind of people who are talked to be, i might be seeing, you know, over representation of worst cases. but i've, you know, the reports, and in the years coming out the cdc or u. k saying the w h o saying that these are generally

a mild presentation of lesions across the body compared to perhaps in what we've seen in the past in the a den of countries in africa. but i'm hearing a lot of cases of men are getting very severe lesions in the and erectile or genital regions that make going to the bathroom extremely painful. some of these men were in the hospital taking opiate treatment. so i have a suspicion and you know, this is not necessarily borne out by the research. i want a cattle to certainly categorize that in that way that i'm not sure. but it seems like pain may be a much bigger problem that some of the ports might be suggesting at this time. all right, well it seems like at least rosamond and yap are nodding in agreement with that assertion. yep. i'm curious in cameroon, and, and across africa, i mean, how challenging is it to diagnose and to test currently and what are the barriers coins to do 1st. and he's got more so the keys up in a very rural environment just to go forward. so you need to have to be able to

point to fossil, indeed to bring to the very specific fill up. in general, for example, do it only one lamp, which you thought the 3rd with a boat to dictate those one. so you imagine for a while we are far too, you have a long old tune up, able to make it a movie to that, to really, really meet the novel 5th. so eventually out of 30 suspect a case we have only 5 that has been confirmed general. if you go to kathy, it might be to say, so either it was mentioned before, we really need to have know this, which i believe also that we can capture to yes, possible. and rosamond, when we go ahead please, i just want to a bit of a new s, you know, we're getting expansion right now into a 10000 cases. for commercial lab, we're getting 5 brought online by the cdc as we speak. so that's going to increase testing for ortho pox virus, which is the family to which i'll get piracy lug it box virus belongs to $58000.00 per week, and then positive cases go on to the cdc for confirmation. so that will help,

but you have to have stores as far as i understand or to test. so you can't test very well in the earlier earlier stages, which makes it harder answered make sure people ice laid prevent and do the contact tracing. so it's a very slow process even now, right. and, and with that in mind, rosamond, i, you know, when we talk about testing and the importance of testing with any virus that spreading at this kind of unprecedented raid. i, you know, i know that they're there, for example, new york city, which is one of the kind of api centers of the outbreak in the united states. there have been, even in the u. s. such huge barriers, they could only test, i think, 10 people a day are the cdc has a monopoly over testing or used to at least at the early days. and i'm curious when you look at testing what, what is most important to you in terms of what needs to happen now, how countries can prepare to prevent this from, from getting out of hand. so testing is, is critical and it's difficult because at the moment we only have pcr, right?

so everyone's really with a pcr, but with cobra, 1900, we moved quickly to well known school cuz we would like to but to rapid tests, we don't have rapid tests for ortho flux versus it's been worked on for for years. and it's not that easy apparently, and so we have to rely for the moment on p t r. so what that means is that you require a laboratory in most situations, you require laboratory setting. there are other technologies that can be brought to bear, but you also need to re, agents. you need the, the primers and the probes, everything that goes into doing a p c r test. and it does take time. it's lab time. it's human resource time it's personnel time. and so that is challenging. what's interesting about this is that it's proving challenging as challenging almost in america as it is in africa and unusual situation, right, right. so i'm sorry. the challenge is if i can just interject on that point, i mean it's kind of shocking that for decades, you know, it's not like corona virus which has appeared to, you know, i know it's related to other viruses but appeared just 2 years ago. i mean, we've known about this as we've heard from, from yup,

it's been around in africa and as you know for decades. so why, why is there no rapid tests, for example, and why don't we know more a go ahead wrap. yep. go ahead. okay, so i was gonna to have all those dates available, you need a lot of money, new look the front fools and research lab institution to find those rub because simply for the vaccine thinking for drugs. so because they're not, they are not been in the funding. oh, it's a good funding and also no market. because if you want to produce that, that you need to have a big market for that. and if you have, or you shoot, getting that africa and you won't have them, i agree with. yep, go ahead, run your investments down. i completely agree. he's been under investment in research and as surveillance, and in, in africa, in general, where the, this disease has, has been emerging for the past 40 years. now what there is,

there is an upside to, to the story. and that's that, that our every country in the world did eradicate smallpox in 19 live declared eradicated 1980. but since that time there, you know, there's been 40 years of ongoing research which has led to what we have today. the chest, we do have to day, the vaccines, we do have to day the treatments. we do have to day, which are still all relatively new. many of them relatively new products. they're still not widely available, although a lot of work is going into that right now. they are the product of actually smallpox preparedness and so on. when years of the good news is we're starting to roll those out as well. so we're not so far behind as we were with cove it at this time. there's a lot more hope involved. in addition to the fact that no one has died from this disease, there's over, i think, a 1000 cases globally outside of africa and have been 3 deaths recently in africa. but no one has died outside of out of this disease so far. so that's encouraging. i mean, when we wrote, when we on youtube, some people are sunny,

ask questions and comments. one of which i'll read george mitchell saying the global response seems very similar to h i. v and aids in the eighty's. i disagree entirely. really? well, that's why we did this what, what is different about it? what is different? well, i hear a lot of talk on twitter. there's a misconception that the problem in the early days of aids was that people over emphasize of how much age is occurring amongst men affected men. i think it's really the opposite. the problem with people ignored a because it was affecting that man and in the united states in western countries, it has always been predominant amongst men. so i don't understand how people got that backward and this, this is occurring predominately as we understand it right now. amongst the men, most monkey foxes and it may fill out more in other populations. we don't know. we need to be on the watch that we also need to speak, frankly, about what kind of behaviors are associated with transmitting the fires at the time . and what people can do to start to think about how they can maybe mitigate their own risk. those are their partners and their members,

their community to back the nation to change their sexual behavior or whatever it might be. thank you, benjamin. it's important to be candidate about all aspects of this conversation, and i want to draw your attention to some comments by dr. mike ryan, the executive director of the w h. e o 's health emergencies program. he talks about how prepared nations are or unprepared for this. so each country has gaps in its readiness caps, in this preparedness gaps in the surveillance. no country is without those gaps. some of those gaps are more extreme. and many of those gaps are because of lack of access and lack of equity, we will see differential impacts and countries. so depending on how strong that wall of immunity is in your community, depending on how well you deal with the vulnerabilities the people have. and depending on how well you're prepared to deal with that, i think we're going to see further ways of disease and i think we will see them have a very differential impact between countries. and there is so much the countries can do now in preparation and in readiness. so rosen like that. yes,

go ahead and transfer question is, what do we feel about the long standing impact of people who were vaccinated for small baths when they were younger people up to 50 years ago? what do we think that'll do to protect people against monkey parks? now, if anything, well, what we've been seeing over the last 40 years is that when the monkey pops 1st emerge, it was 970. and a smallpox is eradicate in ancient 80. so as the cases began to emerge in central africa, but also west africa, we're talking about different plates, different strains of the virus here and, and, and the age was infants, 2 year olds, 5 year olds, young children, and over those 4 decades, the average age of the of the cases appearing and they're all ages actually in africa. but the average age, the median age has actually risen to be young and late adolescents young adults. and this is in heart. i thought the size to be because any one, as you had mentioned, anyone under the age of 50, depending on the country, 4250,

has not been immunized against small clock. so, the hypothesis is there may be some remaining immunity, but of course, you know, i've had that vaccines, but that's a, you know, a long time ago. and, and we don't actually really know whether it was a very, very powerful vaccine. but we don't actually really know whether that immunity is still there. we think that there may be some immunity remaining in that population group. and so there may be some protection in people over 50, around the world. well, we're, you know, what's interesting to me, i was in brazil and i recently arrived in the u. s. and it's interesting to see how certain cities are major cities in the world, new york, washington, dc. i known canada as wells london. they're starting to vaccinate, vaccinate people from the l g b t community, particularly men who have sex with man, or have multiple partners. and it's, it's, i've already seen people doing this sort of traveling to the us trying to get vaccines. but vaccines are, are short even in the us and, and other i've heard, oh, man is going from new york to montreal, detroit again. yeah, yeah. i mean,

we're seeing this sort of, you know, traveling to get this vaccine. is that, is that a positive step? you know, is that something that shocks you? ah, ah, yeah. am, i'm so sorry. i keep getting your name now. forgive me. it's saying it's actually, you know, remind me when we, with the girl who got her condition in to say that you will have with them countries who in the field, the highest risk will keep the dose. it's critical that you see how the talk of those that you make sure that also the unlimited countries will those of smoke like c, because now we are focusing on the, on the gate vision to west, but order to also remember that what he has seen in africa is only to people to i thought because of the testing. so we have to make sure that those vaccine also remain available for the population after now we don't have many knows when to, if i was, we really eat more of, you know,

population people. what's going to happen? yeah. do you have faith that you know now, even though it's frustrating that there is maybe more attention on funding and the importance to fund this, not only in the west where it's happening now, but where it's been happening for decades. do you have faith that that will change, that this is an opportunity for countries in africa to receive the funding? they've been missing this thought that there is a, can you come to look us that, that in central africa repeat on, on one of the drugs or to, to, to treat which was used for more books that may be used for market books. so it's coming, it's coming, but in any we actually want not to come early when everyone emergency, we want the fun to be really bored to fight and to prevent duels. imagine disease. because what we are realizing, we've covey fee ball are now, he's monkey books. is that the right move from one slave work unit 20? yes. and you know, with that in mind, i want to mention that we have many questions and youtube, so our audience is interested in this john beam asking,

what is the mutation rate of the virus? rosamond, i'm gonna ask you about that. but before i do, i want to just piggyback this tweet from jennifer news though about whether or not this is being contained and what needs to be done to do so. it says, some pathogens are biologically not well suited to containment, but monkey pox is a decent candidate for containment. but the u. s. is slow to respond. posture makes her deeply worried that containment of the past pathogen may be out of reach. so what is the mutation rate, and is it out of reach? does jennifer news or have a point here? it's, it's definitely a challenge i've made. so you know this, this disease is as you say, affecting men who have sex with men right now. it's not the only people who can be susceptible to this. providing the right message is really super important. and whether the virus is mutating or not. it, it, it, i apparently had, there had been some changes that were unexpected because normally this d n, a virus is a very stable virus. it doesn't change as quickly as are in

a virus do hack. so we have a lot to learn about. the virus itself, but also how was it transmitting on through as was mentioned by benjamin, by through certain behaviors, but also to not stigmatize we, we need to describe the epidemic as it's happening. we need to describe the epidemic as it's happening in different contexts. and each one of each country, each, each community in different contexts, you know, are best served if they are understand they seek information, understand, trying to understand what's happening in their community, who may be at risk, provide information for those people who are at risk. i was on a call to day with colleagues who were concerned that even if we, we've spent a huge amount of effort actually trying to communicate through community groups through a l, g, b to q, community associations through representatives of specific communities. really getting the message out, social media tiles special and unco created messages. language that is is accepted

and, and, and preferred by, by the community. yeah. and yet somehow, right somehow some pride, festivals. you, he some, some, some of them you see monkey rice everywhere and other others. you don't see it at all. what more? and so it's still uneven. the message is getting out unevenly. of course, of course, and avia. and that's why rosamond, we have the show and why i want to thank you for taking the time to join us. that's all the time we have for today. thanks for watching. see you next time. ah frank assessments. it sounds like you don't expect anything to change the problem in lebanon, it's actually structural lebanon needs, and you also contract in order for it to solve this problem. informed opinions, international communities on the goal of this my security, and thus commutes a government has no legitimacy in depth analysis of the data global headlines. this

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