Stigma and discrimination can be as dangerous as any virus
En un momento que resuena con las grandes tensiones de la salud pública moderna, la Organización Mundial de la Salud declaró el sábado una emergencia sanitaria internacional por el brote de viruela del mono, una enfermedad que durante décadas permaneció confinada en África y que ahora circula en 75 países con más de 16,000 casos confirmados. El director general Tedros Adhanom Ghebreyesus tomó la decisión a pesar de la falta de consenso pleno entre los expertos, reconociendo que la velocidad y la geografía de la transmisión habían cruzado un umbral que no podía ignorarse. Como en otros momentos de la historia epidémica, la humanidad se enfrenta no solo al desafío del virus, sino al de responder con ciencia, solidaridad y sin convertir a las comunidades vulnerables en chivos expiatorios.
- El virus, antes confinado a regiones endémicas de África, irrumpió en 75 países en cuestión de semanas, con Europa concentrando el 80% de los casos y clasificada en nivel de riesgo 'alto'.
- La declaración de emergencia llegó sin unanimidad entre los expertos del comité de la OMS, revelando la tensión entre la cautela científica y la urgencia de actuar ante una propagación sin precedentes.
- El brote se concentra principalmente en hombres que tienen sexo con hombres con múltiples parejas, lo que abre la puerta a una respuesta focalizada pero también al riesgo real de estigmatización social.
- Tedros lanzó un llamado explícito contra la discriminación, advirtiendo que el daño causado por el estigma puede ser tan grave como el del propio virus, una lección aprendida dolorosamente en epidemias anteriores.
- Los sistemas nacionales de salud deberán reforzar vigilancia, capacitar a trabajadores sanitarios y evaluar cadenas de suministro de vacunas y tratamientos, mientras la OMS activa su séptimo máximo nivel de alerta desde 2005.
El sábado, la Organización Mundial de la Salud declaró emergencia sanitaria internacional por el brote de viruela del mono, una enfermedad que había circulado silenciosamente en partes de África durante décadas y que de pronto se encontraba en 75 países, con cerca de 16,000 casos confirmados y cinco muertes registradas. Lo que hacía singular este momento no era solo la escala, sino la geografía: el virus estaba arraigándose en lugares donde nunca antes había circulado, especialmente en Europa, donde los sistemas de salud carecían de experiencia histórica para manejarlo.
El director general Tedros Adhanom Ghebreyesus anunció la decisión dos días después de que un comité de emergencia se reuniera a evaluar la evidencia. El grupo no había alcanzado consenso unánime —algo que Tedros reconoció abiertamente— pero la trayectoria había cambiado desde junio, cuando los casos rondaban los 3,000 y se decidió no declarar emergencia. La velocidad de propagación y la expansión geográfica inclinaron la balanza. Europa concentraba el 80% de los casos globales y fue clasificada con riesgo 'alto', mientras que África, donde la enfermedad es endémica, permanecía en riesgo 'moderado': una inversión del panorama epidemiológico habitual.
Tedros fue explícito en señalar que el brote afectaba principalmente a hombres que tienen sexo con hombres con múltiples parejas. Esta precisión permitía orientar la respuesta de salud pública, pero también abría una puerta peligrosa. El director general hizo un llamado directo a que las comunidades afectadas recibieran información y asistencia con dignidad y respeto a los derechos humanos, advirtiendo contra el estigma y la discriminación que históricamente han acompañado a las epidemias y que pueden volverse tan dañinos como el propio virus.
Esta fue la séptima vez desde 2005 que la OMS activó su máximo mecanismo de alerta, una lista que incluye la pandemia de H1N1, los brotes de ébola, la polio, el zika y el COVID-19. La declaración obliga a los sistemas nacionales de salud a reforzar la vigilancia, capacitar a su personal y revisar el suministro de vacunas y tratamientos. Pero más allá de los requerimientos operativos, el verdadero desafío era montar una respuesta agresiva sin sacrificar la protección y la dignidad de quienes más necesitaban ayuda.
On Saturday, the World Health Organization made a formal declaration that would reshape how the world approached a virus spreading across continents at an accelerating pace. Monkeypox, a disease that had circulated quietly in parts of Africa for decades, had suddenly become a global concern. The numbers told the story: roughly 16,000 confirmed cases across 75 countries, with five deaths recorded. What made this moment significant was not just the scale, but the geography. The virus was establishing itself in places where it had never taken root before, particularly across Europe, where health systems had no historical experience managing it.
Tedros Adhanom Ghebreyesus, the WHO's director-general, announced the decision at a press conference two days after an emergency committee of specialists had convened to weigh the evidence. The committee itself had not reached unanimous agreement—a detail Tedros acknowledged directly. In June, when cases numbered around 3,000, the same group had decided against declaring an emergency. But the trajectory had changed. The virus was moving faster, spreading wider, and the director-general determined that the escalating threat across multiple regions justified the declaration despite the lack of full consensus among experts.
The reasoning centered on a single, troubling pattern: the virus was transmitting rapidly in countries where it had never circulated before. This was the hallmark of a pathogen breaking through established boundaries. Europe bore the heaviest burden, accounting for roughly 80 percent of all cases globally, and the WHO classified the risk level there as high. Africa, where monkeypox had been endemic for decades, remained at moderate risk—a reversal of the usual epidemiological picture that underscored how dramatically the outbreak had shifted.
Yet Tedros was careful to name something else: the outbreak was concentrating heavily among men who had sex with men, particularly those with multiple partners. This specificity mattered because it opened a door to targeted public health response. But it also carried danger. Tedros made an explicit plea for the affected communities to receive information and assistance delivered with dignity and respect for human rights. He spoke directly to a risk that could prove as damaging as the virus itself: stigma and discrimination. History had shown that when disease becomes associated with a particular group, the response can turn punitive rather than protective. Tedros was trying to prevent that.
This declaration marked the seventh time since 2005 that the WHO had invoked its highest alert mechanism. The previous six had included the H1N1 influenza pandemic in 2009, Ebola outbreaks in 2014 and 2018, polio in 2014, Zika in 2017, and COVID-19 in 2020—a status that remained active. Each had demanded mobilization of resources, coordination across borders, and sustained attention from health systems worldwide. Monkeypox now joined that roster.
The practical consequence was immediate: national health networks would be obligated to strengthen their preventive measures. Surveillance systems would need to expand. Healthcare workers would require training on recognition and management. Supply chains for vaccines and treatments would need to be assessed and potentially expanded. But beneath the operational requirements lay a more fundamental challenge: how to mount an aggressive public health response while protecting the communities most affected from the blame and exclusion that often accompanied disease outbreaks. The declaration was a tool, but only if wielded carefully.
Citas Notables
The virus is transmitting rapidly in many countries where there were no cases before— Tedros Adhanom Ghebreyesus, WHO Director-General
Stigma and discrimination can be as dangerous as any virus— Tedros Adhanom Ghebreyesus, WHO Director-General
La Conversación del Hearth Otra perspectiva de la historia
Why did the WHO director override the committee's lack of consensus? That seems unusual.
The numbers were moving too fast. In June there were 3,000 cases. By July there were 16,000. The committee's caution made sense when the outbreak seemed contained, but the virus had started spreading in places it had never been before. At some point the trajectory itself becomes the argument.
Europe has 80 percent of the cases but Africa is where the disease is actually endemic. How does that happen?
The virus didn't suddenly become more dangerous in Europe. What changed is that it found new transmission routes—in this case, networks of people it could move through quickly. In Africa it had been circulating in smaller, more isolated outbreaks for years. Now it was moving through connected populations in cities with international travel.
Tedros specifically mentioned men who have sex with men. Why name that?
Because you can't respond to what you won't name. If you want to reach people with information and vaccines, you have to know where the virus is actually spreading. But he was also warning against what happens next—the moment when a disease becomes a moral accusation instead of a medical problem.
Is that warning realistic? Can you really prevent stigma once it starts?
You can't prevent it entirely. But you can refuse to participate in it. You can make sure the response is about protecting people, not punishing them. That's what he was asking health systems to do.
What happens now that it's declared an emergency?
National health systems have to act. Surveillance expands, resources flow, coordination happens across borders. But the real test is whether they do it in a way that actually reaches the people who need help, or whether fear drives them to isolate and blame instead.