TJ Coles explores how the Government has reacted to months of alerts about the growing Monkeypox threat

In recent days, the World Health Organisation has warned that 80 cases of Monkeypox – a viral disease first discovered 60 years ago – was present in 11, non-endemic countries; meaning countries with populations who have no immunity to the virus.

At the time of writing, the most recent statement from the UK Health Security Agency (UKHSA) puts the number of infected UK residents at 20.

Health and Social Care Secretary Sajid Javid recently confirmed that the Government has procured more doses of Smallpox vaccines in an effort to prepare against further Monkeypox spread.

But documents seen by Byline Times show that international health and security experts had anticipated an outbreak of the virus last November – even predicting the month (May) in which the virus was likely to spread.

Despite this, the UKHSA just last month rated the threat of Monkeypox as “very low”. 

The UKHSA – launched in April 2021 – got off to a bumpy start, with professional papers decrying the agency’s lack of structural clarity and clear chain of responsibility.

More recently, as it underestimated the Monkeypox threat, industry publications noted that the UKHSA announced plans to cut 40% of its workforce – some 800 staff. Department of Health and Social Care (DHSC) officer, Jawad Raza, tweeted: “Staff morale is indeed very low and this process isn’t being handled well, experienced staff are now looking to move elsewhere.”

According to the US Centers for Disease Control and Prevention (CDC), Monkeypox belongs to the Orthopoxvirus genus of the Poxviridae family, which includes variola virus; the same that causes Smallpox. It was first discovered in 1958 in caged, lab animals, which are often a reservoir for diseases.

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The first human cases were reported in 1970 in what is now the Democratic Republic of Congo. Since then, the virus has spread to neighbouring African countries and is endemic. Human travel and animal importation have, historically, been two factors that have spread the virus to the West, which lacks immunisation.

Generally less severe than Smallpox but apparently deadlier than COVID-19, according to the CDC, symptoms can last up to one month and include rashes, swollen lymph nodes, fever, headache, and exhaustion.

Animal-to-human transmission can occur from bites and scratches, while human-to-human transmission can result from close contact with infected persons via the respiratory tract, mucous membranes, and open skin. 

The Nuclear Threat Initiative is a think tank that deals with the eponymous issue of biological events, as well as disarmament and proliferation studies for biological and chemical weapons and agents. Its members include former US Secretary of Energy Ernest Moniz, the media giant Ted Turner, and former US Food and Drug Administration commissioner Margaret Hamburg. Britain’s own former Foreign Secretary Malcolm Rifkind is also on the board of directors.

In a speculative exercise by the Nuclear Threat Initiative, a Monkeypox outbreak begins on 15 May 2022 in a fictional country, infecting more than 1,400 people and killing four. There were “no international warnings or advisories”. By the following January, 1.3 million are dead as the virus becomes vaccine-resistant. The Monkeypox “was caused by a terrorist attack using a pathogen engineered in a laboratory with inadequate biosafety and biosecurity provisions and weak oversight”. Three billion are infected and 270 million die.

The fictional disaster highlighted the need for better detection systems, closure of national preparedness gaps, and more financing for biosecurity.

Institutional Inaction

Despite the high-profile nature of the organisations involved in planning and publishing the report, the Government appears to have taken no action beyond existing, under-funded monitoring programmes.

As it stands, just 19 results are returned when typing “Monkeypox” into the website. The earliest mention of it is from September 2018, when Public Health England (PHE) identified and isolated three individuals diagnosed with the virus. Also in that year, Porton Down research laboratories reported their apparent success in developing at least one Monkeypox vaccine candidate and three therapeutics. What is not confirmed, however, is how much money the Government spent perfecting the vaccine to obtain a license or if the vaccine is already licensed.

In January 2019, PHE also listed Monkeypox as present in the UK, spread by rats, along with dozens of other zoonotic diseases. After SARS-CoV-2 struck, PHE later reported its new infectious disease strategy to tackle, among other things, Monkeypox.

But within a year, then Health and Social Care Secretary Matt Hancock announced plans to scrap PHE and merge it into a new body called National Institute for Health Protection. The Government’s November 2020 policy paper, ‘UK Pandemic Preparedness’, merely lists Monkeypox in the context of the Government boasting about previous success stories.


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A March 2021 statement on the new UK Health Security Agency doesn’t mention the body’s role in detecting and combating Monkeypox, but rather that the director, Dr Jenny Harries, has prior experience tackling the virus.

Back in 2008, New Labour’s UK National Security Strategy (NSS) warned of an inevitable pandemic. It said “the highest risk is an influenza-type pandemic, like the outbreak in 1918 which killed 228,000 people in the UK and an estimated 20-40 million worldwide”.

It added that “experts agree that there is a high probability of a pandemic occurring – and that, as the SARS (severe acute respiratory syndrome) outbreak [in 2003] showed, the speed at which it could spread has increased with globalisation”.

The NSS concluded that “a pandemic could cause fatalities in the UK in the range 50,000 to 750,000, although both the timing and the impact are impossible to predict exactly”.

Instead of taking the warnings seriously, successive Conservative governments have undermined public health organisations.

The Health and Social Care Act 2012 further fragmented and privatised the NHS. In 2013, the British Medical Association (BMA) provided evidence to the House of Commons that “the fragmented nature of the new health system will require that each organisation… [is] aware of the plans in place to deal with potential outbreaks of ill health, such as pandemic flu or legionnaires disease”.

The BMA warned that “the Health and Social Care Act 2012 is not clear on these lines of responsibility. As such, it is possible that different areas of the country will develop different ways of dealing with outbreaks”.

It concluded that this will be “problematic for those organisations that have a national role and who will therefore have to tailor their responses to local plans. This could lead to inefficiency, duplication of effort and ultimately put lives at risk”.

This is exactly what happened when COVID-19 struck – and it could yet happen again.


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