“At the height of the mpox outbreak last summer, we couldn’t really focus on anything else, but once the number of mpox cases decreased, we went back to our normal lives. Still, we didn’t think: mpox is over now. We thought: mpox might pick up again in 2023 or in 2 to 3 years,” says Fabrice Pilorge, Advocacy Director at AIDES, an organization leading the fight against HIV/AIDS and viral hepatitis in France.
So, what is AIDES doing now, nearly a year since the peak of the mpox (monkeypox) outbreak in the WHO European Region, an outbreak that has predominantly affected gay, bisexual and other men who have sex with men (GBMSM)?
The organization, which counts more than 2000 staff and volunteers in France, focuses on encouraging people living with HIV and other affected communities to get their second mpox vaccine dose, or to get vaccinated if they have not yet done so. It is also reigniting conversations about mpox.
“Apart from our mandate, we have a particular focus on people living with HIV because they are at greater risk of severe disease if they get the mpox virus. It is with this group [people with untreated and advanced HIV infection] that there are deaths and severe health complications to prevent,” says Franck Barbier, Programme Manager at AIDES.
“Last year, we saw people in severe pain, and helped them with pain relief so that they didn’t have to get hospitalized. This year, we are reminding people to protect themselves and others, to check regularly for symptoms, and to bear in mind how to recognize symptoms so that they can act quickly if needed.”
He adds, “We are not an association of doctors or nurses, but recently we have been running sexual health clinics and offering health advice and care to people affected by mpox.”
Franck and his colleagues have noticed that interest in mpox-related health advice and care has picked up since spring, when requests for vaccination started coming in again.
AIDES has played a vital role in extending vaccination services and bringing them closer to affected communities. There are some 200 places across France where affected communities can get vaccinated against mpox. These include hospitals and sexual health clinics, but also some pharmacies and AIDES centres in major cities.
With over 160 000 immunized people as of April 2023, France may have vaccinated the highest number of people in Europe against mpox, based on publicly reported numbers.
However, many people at elevated risk of mpox remain unvaccinated. As international travel and events where sexual activities might occur pick up this summer, mpox cases could pick up too. AIDES’s efforts to jumpstart interest in vaccination and completion of the vaccine series is therefore timely.
Paving the way for stamping out mpox
The work of AIDES, together with France’s health authorities, has included numerous initiatives that have helped bring the number of mpox cases down since last summer and kept it low since. Making mpox vaccination, tailored health advice and care more accessible has been key – but it’s been much more than that.
For example, to help people with mpox cope with loneliness and anxiety during a 21-day self-isolation period, AIDES created a Telegram group last summer, reaching some 500 people. To help control the spread of mpox infections, AIDES also created an online tool with which people with mpox can warn sexual partners and other contacts of potential mpox exposure, anonymously.
Even though mpox is currently not classified as a public health emergency of international concern, AIDES is not complacent. In addition to reigniting conversations on mpox and urging health authorities to do the same this summer and autumn, and encouraging affected communities to get vaccinated, AIDES continues to engage with health authorities and WHO/Europe on a long-term plan to control and eventually eliminate mpox in France.
WHO/Europe’s campaign to control and eliminate mpox
In June 2022, WHO/Europe convened an informal working group to co-develop risk communication, community engagement and infodemic management (RCCE-IM) messages and materials with community insights, and to share community engagement interventions for the mpox outbreak.
AIDES is one of 30 civil society organizations that participated to bring community perspectives into the response and to share tips for reaching affected communities while developing the RCCE-IM mpox toolkit and the mpox elimination policy brief.
On 17 May 2023, at the 1-year mark of the mpox response in the Region, WHO/Europe launched the campaign “Eliminating mpox: Placing affected populations at the heart of our response” to spur action by affected communities, civil society organizations, health authorities and providers to control and eliminate mpox in the Region.
The campaign is inspired by WHO/Europe’s latest mpox policy brief, which outlines the actions countries in the Region need to take to prepare for this season’s mass gatherings, and to prevent the spread of mpox in the medium to long term.
Actions include making testing and vaccination more accessible and bringing them closer to affected communities, along with integrating the mpox response into national sexual health programmes – actions that AIDES and France’s health authorities have already shown are possible.