Stigma and discrimination can be as dangerous as the virus itself
En las últimas semanas de julio, la Organización Mundial de la Salud elevó el brote de viruela del mono al nivel más alto de alerta sanitaria global, su séptima declaración de emergencia desde 2005. Con dieciséis mil casos confirmados en setenta y cinco países y una presencia abrumadora en Europa —continente donde el virus nunca había circulado— la velocidad de transmisión en territorios sin inmunidad previa fue el umbral que cruzó la decisión. La declaración no resuelve la crisis, pero obliga al mundo a mirarla de frente y a actuar con coordinación, cuidando que la respuesta proteja tanto la salud como la dignidad de las comunidades más afectadas.
- El virus se expandió de tres mil casos en junio a dieciséis mil en julio, cruzando fronteras con una velocidad que dejó sin efecto la cautela inicial de los expertos.
- Europa concentra el ochenta por ciento de los contagios globales, convirtiendo a un continente sin historia con la enfermedad en el epicentro de una emergencia que durante décadas fue africana.
- El comité de especialistas de la OMS no logró consenso, pero el director general Tedros Ghebreyesus tomó la decisión unilateral de declarar la emergencia al constatar la transmisión simultánea en múltiples regiones.
- La alerta recae con mayor peso sobre hombres que tienen sexo con hombres y múltiples parejas, lo que exige una respuesta epidemiológica que no derive en estigma ni discriminación.
- La declaración activa obligaciones concretas: reforzar la vigilancia, ampliar las pruebas diagnósticas y preparar los sistemas de salud nacionales para una escalada que aún no ha tocado techo.
Un sábado de finales de julio, la OMS hizo oficial lo que los epidemiólogos observaban con creciente inquietud: la viruela del mono había cruzado el umbral de emergencia sanitaria global. No era solo la cifra —dieciséis mil infectados, cinco muertos, setenta y cinco países— lo que pesaba en la decisión, sino dónde estaban ocurriendo esos contagios. Europa, donde el virus nunca había echado raíces, acumulaba el ochenta por ciento de los casos mundiales.
El camino hasta la declaración no fue lineal. En junio, cuando los casos rondaban los tres mil, el mismo comité de expertos había optado por la prudencia y no activó la alerta. Pero las semanas siguientes reescribieron el mapa: el virus ya no circulaba solo en las regiones donde llevaba décadas presente, sino que se instalaba con rapidez en territorios sin inmunidad previa. Ante esa trayectoria, y pese a que el comité no alcanzó unanimidad, el director general Tedros Ghebreyesus decidió que el umbral había sido superado.
Ghebreyesus señaló que el brote se concentraba especialmente entre hombres que tienen sexo con hombres y múltiples parejas, y advirtió que el estigma y la discriminación podían resultar tan peligrosos como el propio patógeno. La respuesta global, insistió, debía llegar a las comunidades afectadas con información y apoyo, pero sin sacrificar su dignidad ni sus derechos.
Europa quedó en nivel de riesgo 'alto', mientras el resto del mundo —incluida África, donde la enfermedad es endémica desde hace décadas— se mantuvo en riesgo 'moderado'. Esta inversión epidemiológica subrayó la novedad del momento. La declaración, séptima en la historia del mecanismo creado en 2005, se sumó a hitos como la gripe H1N1, el ébola, el zika y la COVID-19. Su función no es resolver la crisis, sino obligar a los países a reforzar vigilancia, ampliar diagnósticos y preparar sus sistemas sanitarios para lo que pueda venir.
On a Saturday in late July, the World Health Organization made official what epidemiologists had been watching with growing alarm: monkeypox had become a global emergency. The declaration came after the virus had already seeded itself across seventy-five countries, with roughly sixteen thousand confirmed infections and five deaths. What made this moment significant was not just the raw numbers, but where those numbers were appearing. Europe, a continent where monkeypox had never established itself before, now held eighty percent of all cases worldwide.
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 question. The committee's deliberation revealed the complexity of the moment: there was no unanimous agreement among the experts about whether to sound the alarm. Yet Ghebreyesus, looking at the trajectory of transmission across multiple regions simultaneously, decided the threshold had been crossed. The virus was moving fast through populations that had no prior exposure to it, and that pattern demanded a formal response.
The path to this declaration had not been straightforward. When the same committee met in June, monkeypox cases numbered around three thousand. At that point, the experts had chosen restraint, declining to declare an emergency. But in the intervening weeks, the situation had shifted dramatically. The virus was no longer contained to the regions where it had circulated for decades. It was establishing itself in new territory, and doing so with speed.
Ghebreyesus identified the core criterion that tipped the decision: the virus was transmitting rapidly in countries where it had never been seen before. He also noted that the outbreak was concentrating heavily among men who have sex with men and who have multiple partners. This specificity mattered not just epidemiologically but ethically. The WHO chief emphasized that the global response had to include support and education for the affected communities, but crucially, it had to do so in ways that protected their dignity and human rights. He warned that stigma and discrimination could prove as dangerous as the pathogen itself.
Europe's situation warranted particular attention. The continent's risk level was elevated to "high," reflecting the density and velocity of transmission there. The rest of the world, including Africa where monkeypox had been endemic for decades, remained at "moderate" risk. This inversion—where a disease native to one region posed greater immediate threat in another—underscored how the global outbreak had rewritten the epidemiological map.
The emergency declaration was the seventh of its kind since the WHO established this mechanism in 2005. Previous declarations had marked pivotal moments in recent public health history: the 2009 H1N1 influenza pandemic, the 2014 and 2018 Ebola outbreaks, polio in 2014, Zika in 2017, and COVID-19 in 2020, which remained under the highest alert status. Monkeypox now joined that roster of threats deemed serious enough to demand coordinated global action and mandatory increases in preventive measures across national health systems.
The declaration itself was a tool, not a solution. It would compel countries to strengthen surveillance, increase testing capacity, and prepare their health infrastructure for what might come next. But it also carried a message: the world was watching, and the world was taking this seriously. For the communities most affected, the challenge would be navigating that attention carefully—seeking the support and information they needed while resisting the forces that might use the outbreak as cover for discrimination.
Notable Quotes
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
The Hearth Conversation Another angle on the story
Why did the WHO wait until sixteen thousand cases to declare an emergency, when they'd already seen three thousand in June?
The committee didn't have consensus then. Three thousand cases, even growing, didn't yet feel like a global crisis—it looked more like a regional problem. But by July, the virus had jumped into seventy-five countries. That's the difference between a fire in one building and fires breaking out across the city.
And the fact that eighty percent of cases are in Europe—a place where this virus has never lived before—that's what changed the calculus?
Exactly. Monkeypox had been circulating in Africa for decades. Health systems there knew how to manage it. But Europe had no immunity, no experience, no infrastructure built for it. Rapid spread in naive populations is always more alarming than steady transmission in places that have adapted.
Tedros mentioned the outbreak is concentrating in men who have sex with men. Why is that detail important enough to highlight in a global emergency declaration?
Because it's the truth, and because how you name the truth matters. If you hide it or generalize it away, you can't actually reach the people who need help. But you also have to say it carefully—he was explicit about protecting dignity and rights. The virus doesn't care about stigma, but people do, and stigma kills in its own way.
Is declaring an emergency actually going to stop the spread, or is it mostly symbolic?
It's not symbolic at all. It mandates that national health systems increase their preventive measures. It triggers funding, coordination, research prioritization. But you're right that a declaration alone doesn't stop a virus. What it does is force governments to act as if the threat is real.
This is the seventh emergency declaration since 2005. Are we declaring emergencies more often, or are emergencies actually becoming more common?
Both, probably. The mechanism exists now, so it gets used. But the pattern is real too—more spillover events, more rapid global spread. The world is more connected. Viruses move faster than they used to.