ANKARA

Humanity must start rethinking its relations with nature to prevent further pandemics, public health experts told Anadolu amid an mpox outbreak that has left the world on edge, fearing a return to the COVID era.

People returned to their previous lifestyles despite knowing that new pandemics were likely on the horizon, said Jean-Daniel Lelievre, a professor of clinical immunology, vaccination specialist and expert consultant to the French National Immunization Technical Advisory Group (NITAG) and European Medicines Agency (EMA).

"We must bear in mind that this is all related to our lifestyles, to climate change … We are in contact with a natural habitat that we are not used to. We will attract some pathogens. And given the size of contact that we have among us human beings, we will see those epidemic phenomena," Lelievre told Anadolu.

He stressed that as human beings destroy the environment and natural habitats, there is more and more contact with animals that already carry some viruses.

"Then we encourage human contacts. Thus the adaptation of the virus to human beings, and then an explosion. This is what we observed with HIV,” the virus behind the AIDS epidemic that exploded in the 1980s and ‘90s, he said.

“HIV was probably confined in African populations for a very long time, and then with the colonization of Africa … the virus found better welcoming populations to mutate rapidly and cause pandemics.”

"We can develop vaccines. We can develop strategies. But if we do not modify the environment, it will certainly all repeat," he warned.

Dr. Mehmet Ceyhan, head of the Infectious Diseases Association based in Ankara, Türkiye, said the primary and the intermediate hosts of those viruses were always wild animals.

"For example, flu is a bird disease," he said, adding that COVID-19 came from a virus found in bats.

"There are some spots where the animals who migrate from Siberia to Africa are used to stopping over for hundreds of years now. If human beings go and install houses there and make contact with those birds, the viruses that they used to carry without any harm would create pandemics for human beings,” he warned.

“If you do not make contact with monkeys and leave them in their natural habitats, there is no chance of this disease affecting you. Unfortunately, human greed damages nature and hits us back as a pandemic. It can’t go on like this. If we continue like this, the world might end one day with a pandemic."

- Countries’ preparedness levels called into question

Starting over four years ago, COVID-19 – a respiratory disease that still haunts the globe, although it has lost intensity – so far claimed over 7 million lives, according to World Health Organization (WHO) figures. The pandemic exposed the vulnerability of health care systems even in developed countries, and the current mpox outbreak raised questions about whether the governments and international institutions have learned their lessons for new crises in the future.

"Scientists are prepared, but the politics not at all," said Lelievre, explaining that no precautions were taken for mpox beforehand.

"It is like nothing was learned, and there we have the WHO that declares a global emergency (on mpox last month). We need to wake up. All the governments are waking up now," he stressed, decrying how political institutions only have short-term vision, and the lack of communication and financial possibilities make it harder to tackle the issues.

Ceyhan noted that there are currently other active pandemics around the globe, including zika and dengue fever, which have not yet affected Türkiye, since the creatures spreading them – various species of mosquitoes – are not in the country.

"But we have observed many new species of mosquitoes in recent years (in Türkiye). So we must extend our pandemic preparedness plans in some way," he urged.

"The lesson learned from COVID-19 should be this: We must have the mindset to be prepared for a pandemic in general. Do we have this mindset?" he said, quickly giving the answer: “No.”

He also told how after the COVID-19 outbreak, states decided to take joint global measures and centralize laboratory work across the globe, to share information on possible mutations – a project that was later abandoned due to a lack of finances.

"Preventive medicine was put aside and forgotten. The fight against the pandemic, however, is not done in hospitals and intensive care units. (But) that is only the fight against the consequences of the pandemic. The fight against the very pandemic should be done in the field, to prevent it. There are many countries that could help the Democratic Republic of Congo, to vaccinate all the population and prevent the virus from circulating," Ceyhan said.

He said the US was the country hit hardest by the mpox epidemic in 2022, but that it could have helped eradicate the disease right on the spot in Congo with much less money than it spent at the time on American soil.

Ceyhan emphasized another major issue, namely knowledge of poxviruses, the larger group that includes mpox and smallpox, which is caused by the variola virus.

“I haven’t seen variola. The last case in Türkiye was in 1958, it was 1972 for the entire world, and vaccinations ended in the 1980s. None of the current crop of doctors know about variola,” he said.

A potential solution, he suggested, is to have a visual online database resource for doctors to help them in diagnosis and avoid misidentifying skin rashes possibly caused by other diseases.