was no factual basis for this related reports. over the years, china and the pacific islands form have enjoyed good co operative relations. what i want to stress is that china has never interfered in the internal affairs of the pacific island countries. but the struggle for influence is likely to remain at or near the top of the agenda throughout this forum. but away from the meetings there is little or no interest in the big names who have come to town. fijians are dealing with the reality of a will changing around them and what it might look like, the generations to come. wayne, hey, al jazeera zuba. ah, this is our deceiver. these are the top stories. the you are the security councils pasta resolution to extend a deliveries to the last rebel held area in north western sylvia for 6 months. permission for cross border shipments from turkey expired on monday, after russia vetoed an attempt to renew the mandate for the year. you can basset to

the un says the resolution won't ease the suffering and uncertainty of displaced syrians. we've heard repeatedly from the un and from angie owes that a renewal for 12 months was necessary to provide operational certainty. so they could prepare to meet that humanitarian need, especially during the harsh months of winter. last friday, russia stopped this from happening. with today's vote, innocent syrians can breathe no sigh of relief, the suffering and the uncertainty goes on. without the confidence of at least 12 months, un agencies and anteaus risk being caught in a perpetual cycle of pre positioning and contingency planning. the euro hit parity

with you as a dollar and trading and tuesday. that's the lowest valuation of europe's currency in 20 years. it's driven by fears of a global recession and uncertainty over energy supplies. marley's military says it's arrested nearly 50 people. it says a soldiers from ivory coast who would accuse us of being mercenaries. and you are in the spokesman says they provided logistic support to its peacekeeping. mission and private funerals been held in tokyo for former prime minister since obee, people lined the streets of the capital to pay their final respects, as body has been taken from the zillow, suzy temple, to the funeral home. a small pacific island nation of kid abbas has withdrawn from a crucial fiji based regional block. it says micronesia countries have been sidelined in the leadership of the pacific island forum. and the 1st full color image from the largest and most powerful observatory ever sent into orbit has been

released. the picture was taken by the james web space telescope and its brimming with distant galaxies and stars. coming up next. and abdulla, it's the stream. good bye. for now. it's rush hour at the local community center in lieu batch of 15 kilometers from the florida lake ukraine. that note that cuts jack is a retired russian language teacher and is collecting goods donated by people from all over europe. thought i and we are helping people on the other side of the board to once the state behind can plead. since russia invaded ukraine, that new to has been driving across the border every day. crossing the border is always tricky, but the women say that today they have a lucky day because the border guard is someone they know and it's going to be hopefully much easier to bring to the goods. in that notice we leave to find

a less chaotic situation. that in the past few days, people seem less exhausted. just i'm, i'm not crying. as you can see, that not us mission has been accomplished now, but you will return with more goods as long as rush us missiles and rockets for people out of ukraine with . welcome to the stream, i'm at cyber 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 warn 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 chop, you too can be part of today's conversation. ah,

new cases of monkey pox continued 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, science journalist based in new york city in geneva, dr. rosamond lewis of the world health organization and, and he 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 hear 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 skin to skin contact, kissing contact with clothes or bedding that has 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 scaling because that's the only way we're going to be able to contain it for them and you heard her say we need more testing. and if i'm not mistaken, i understand is primarily transmitted through skin to skin contact. what do we need to know about monkey pox in your mind? well, monkey pox is a disease. it's that is related to what used to be smallpox, which was eradicated in 1980. right. so we spent 40 years with a learning about monkey box 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 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 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, forgive me with forget me up. i actually can go if you ever won't have good. thank you. so what is quite interesting grief that morgan of our great keeps remaining us how we are interconnected and how you interdependent within was mentioned,

duckies on, or disease that has been indian making many african countries in kangaroo, dfcs, cow. and now all of the blue you can see happening all over the west. so it reminds us how we miss. make sure that we control or do emergency even when we don't think that they will join the western countries. we come in 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 it cases 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, 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, 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, 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 he's 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 mcgee pox in his global outbreak or 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 i've 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 of 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 opioid treatment. so i have

a suspicion and you know, this is not necessarily borne out by the research. i want to cancel just early categories that in that way that i'm not sure. but it seems like pain may be a much bigger problem than 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? he's coins telling the truth and he's got most of the keys up in a very rural environment just to go forward. so you need to have to be able to wanting to fumble, indeed, to bring to the very specialized luck in german for example. doing only one lump, which you thought that the 3rd was able to dictate those one to you maggie, for one of our fall 2, you have long or 2. not able to make it easy to that to really, really meet the novel 5th. so eventually alpha turnkey suspected case,

we have only 5 that i've been confirm general. if you go to cathy, it might be the same. so either it was mentioned before, we really need to have know this, which i believe also there can can capture to yes possible. and rosamond when we go ahead please, i just want to wrap it up at the u. s. you know, we're getting expansion right now into a 10000 cases. for commercial lab, we're getting fired, 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 monkey 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 isolate, 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 rate, 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 uh pcr, right? so everyone's really with the pcr, but with covered 19 we moved quickly to, well, maybe not as quick as we would like to, but to rapid tests. we don't have rapid tests for ortho bucks, viruses it's been worked on for, for years. and it's not that easy apparently. and so i, we have to rely for the moment on p c 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 the reagents. 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. yeah, there's an unusual situation, right, right. so it, i'm sorry that you're a challenge. if i've are interested in or jacked 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, ah, yup, it's been around and africa and as you know for decades. so. so why did it, why is there no rapid task, for example? and why don't we know more a go ahead wrap. yep. go ahead. oh, good. so i was in the to have all those days available. you need a lot of money,

new look to front fools, a research lab institution to find those rub because simply for the vaccine thinking for drugs. so because they're not, they have not been in the funding all, it's a good funding and also know 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 them africa and you won't have them. i agree with. yep, go ahead, run your investment 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 are, every country in the world did eradicate smallpox in 19 lives declared eradicated 1980. but since that time there, you know, just 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 are the good news is we're starting to roll those out as well. so we're not so far behind as we were recovered 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 age 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 with men 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 men, most muggy 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 capsule, surveillance, no countries 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 that 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 rosa like that, yes, go ahead and transfer question is, what do we feel about the last, any 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 m monkey pops 1st

emerge, it was 970, and a small boxes eradicate and 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 adolescence young adults. and this is in part i bought 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, major cities in the world, new york, washington dc. i known canada as wells london. they're starting to vaccinate, vaccinate people from the algebra, 2 community, particularly men who have sex with man, or have multiple partners. and it's, it's, i've already seen people doing the 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 all a man's 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, yes ma'am. i'm so sorry. i keep getting your name. now. forgive me. it's saying it's actually to remind me when we, with the girl who got her condition into status that you will have with them.

countries with the highest we will keep the dogs, it's critical that you see how the talk of those that you make sure that also the enemy countries with those of a smoke like c, because now we are focusing on the, on the gate a west of but you also remember that what you have 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 vino 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 fact that there is a, can you compare?

let us let that in the central africa repeat on, on one of the drugs or to, to, to treat which was used for small books that may be useful multiple to each coming . it's coming, but we actually want each not to come early when everybody emergency we want the phone to get really bored to fight and to prevent duels. it mentioned disease because what we are realizing we've quote lead we people are now if monkey box is that the right move from one place, one apart unit to yes. and you know, with that in mind, i want to mention that we have many questions in youtube, so our audience is interested in this john beam asking, what is the mutation rate of the virus? rosamond, i'm going to 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 our neighbors do a 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 knock stigmatized. 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, try to understand what's happening in their community, who may be at risk provide. ringback formation for those people who are at risk. i was on a call today with colleagues who were concerned that even if we, we 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 the community. yeah. and yet somehow, right somehow some pride of 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. so your next time. ah oh, he got a gun eating ideals, the french republic, islam for a claim, but just what is modern? france in a 4 part series. the big picture takes an in depth look. episode 3 on al jazeera with, well, there's only 4 months to go to the world cup and the clock is ticking as teams and fans prepare the cattle. at 2022, we'll have updates from different regions across the globe. this month. the focus

is on africa and synagogue mounts a challenge for the trophy to winning the africa cup of nations will be cameroon. gonna to nicea, omar, o, cope, it's the alicia. join us for the world. go count down on al jazeera ah, allow government. now jesse a this is al jazeera ah, you're watching the news our life.