‘Warn Everyone’: Spain’s Gay Community Acts as Monkeypox Spreads

Whether it’s abstinence, avoiding nightclubs, limiting sexual partners or pushing for a swift vaccine rollout, Spain’s gay community is on the front line of the monkeypox virus and is taking action. 

“With this monkey thing, I prefer to be careful. … I don’t have sex anymore, I don’t go to parties anymore, and that’s until I’m vaccinated and have some immunity,” said Antonio, a 35-year-old from Madrid who declined to give his last name. 

Antonio, who often went to nightclubs and sometimes to sex parties, decided to act as cases continued to increase. 

Spain on Saturday reported its second monkeypox-related death. 

Outside of Africa, the only other such death has been in Brazil. 

More than 18,000 cases have been detected throughout the world outside of Africa since the beginning of May, according to the World Health Organization (WHO). 

Spain is one of the world’s worst-hit countries. The health ministry’s emergency and alert coordination center put the number of infected people at 4,298. 

As cases increase globally, the WHO has called on the group currently most affected by the virus, men who have sex with men, to limit their sexual partners. 

Lack of vaccines 

“This is not like Covid, the vaccine already exists, there’s no need to invent it. If it wasn’t a queer disease, we would have acted more — and faster,” said Antonio. 

Like other members of the gay community, he believes the authorities have not done enough. 

NGOs have denounced a lack of prevention, a shortage of vaccines and stigmatization linked to the virus.  

This is despite the WHO declaring the monkeypox outbreak a global health emergency. 

Early signs of the disease include a high fever, swollen lymph glands and a chickenpox-like rash. 

The disease usually heals by itself after two to three weeks, sometimes taking a month. 

A smallpox vaccine from Danish drug maker Bavarian Nordic, marketed under the name Jynneos in the United States and Imvanex in Europe, has been found to protect against monkeypox. 

It took Antonio three weeks to get an appointment to be vaccinated, after logging on to the official website every day at midnight. 

Appointments “are going as fast as tickets to the next Beyonce concert,” another said. 

So far, Spain has only received 5,300 doses, which arrived in late June. 

The Spanish health ministry declined to comment when contacted by AFP. 

‘Anyone can catch it’ 

Nahum Cabrera of the FELGTBI+ NGO, an umbrella group of more than 50 LGBTQ organizations from all over Spain, insists there is an urgent need to vaccinate those most at risk. 

That means not just gay men, but anyone who has “regular sex with multiple partners, as well as those who frequent swingers’ clubs, LGTBI saunas, etc.,” he said. 

“It risks creating a false sense of security among the general population, and they relax into thinking that they are safe and that it only happens to men who have sex with men,” he said. 

The target age group for vaccination is those ages 18 and 46, he added. 

Older people are vaccinated against smallpox which was eradicated in Europe in the early 1970s. 

“We are facing a health emergency… that affects the LGBTI community, so people think it is insignificant, that it is not serious,” said Ivan Zaro, of the Imagina MAS (Imagine More) NGO. “This is exactly what happened 40 years ago with HIV.” 

Image director Javier spent three days in hospital in early July after becoming infected.   

The 32-year-old, who is in a monogamous relationship, said he still did not know how he had caught it. 

“I warn everyone,” he said. “It’s an infectious disease, anyone can catch it.” 

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New York City Declares Monkeypox Public Health Emergency

New York has declared a public health emergency due to a monkeypox outbreak.  Mayor Eric Adams and Department of Health and Mental Hygiene Commissioner Dr. Ashwin Vasan made the announcement Saturday.

The two officials said in a joint statement that “New York City is currently the epicenter of the outbreak, and we estimate that approximately 150,000 New Yorkers may currently be at risk for monkeypox exposure.”

“Over the past few weeks, we have moved as quickly as possible to expand outreach and access to vaccines and treatment to keep people safe,” the officials said.  “We will continue to work with our federal partners to secure more doses as soon as they become available. This outbreak must be met with urgency, action, and resources, both nationally and globally, and this declaration of a public health emergency reflects the seriousness of the moment.”

On Friday, New York state Governor Kathy Hochul issued an executive order declaring a state disaster emergency because of the monkeypox outbreak. In her executive order, Hochul said that “More than one in four monkeypox cases in this country are in New York State.”  Her declaration also expanded the number of health care individuals who can administer the monkeypox vaccines.

The World Health Organization has declared the global monkeypox outbreak a public health emergency of international concern.

WHO chief Dr. Tedros Adhanom Ghebreyesus said recently that while 98% of global monkeypox cases “are among men who have sex with men, anyone exposed can get monkeypox, which is why WHO recommends that countries take action to reduce the risk of transmission to other vulnerable groups, including children, pregnant women and those who are immunosuppressed.”

Tedros said, “In addition to transmission through sexual contact, monkeypox can be spread in households through close contact between people, such as hugging and kissing, and on contaminated towels or bedding.” 

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Pelosi Confirms Asia Visit, Doesn’t Mention Taiwan

U.S. House Speaker Nancy Pelosi confirmed Sunday she is leading a congressional delegation to Asia but did not mention whether she will defy China by making a stop in Taiwan.

In a statement, Pelosi said she is leading a group of five other Democratic Party lawmakers to Asia “to reaffirm America’s strong and unshakeable commitment to our allies and friends in the region.”

The trip will include stops in Singapore, Malaysia, South Korea and Japan, the statement said. The group already stopped in Hawaii, where it received a briefing from the U.S. military’s Indo-Pacific Command, it added.

U.S. media reports Friday suggested Pelosi was tentatively planning to stop in Taiwan. Pelosi herself has indirectly spoken about such a possibility, even though her office has not confirmed it, citing security protocols.

It would be the highest-level U.S. visit to Taiwan since 1997, when former House Speaker Newt Gingrich led a congressional delegation there.

China had repeatedly warned Pelosi’s trip would be an unacceptable violation of what it sees as its sovereignty over the self-ruled island.

Taiwan and China split in 1949 after a civil war, with the defeated nationalist forces fleeing to Taiwan and setting up a government that later grew into a vibrant democracy.

Since then, China’s Communist Party has vowed to take Taiwan, using force if necessary, even though the island has never been led by the Communist Party.

Chinese leaders strongly object to U.S. shows of support for Taiwan’s government, which they see as illegitimate.

In a Thursday phone call with U.S. President Joe Biden, Chinese President Xi Jinping issued a blunt warning over Taiwan, saying “those who play with fire will perish by it,” according to a Chinese government readout.

China’s foreign ministry has also vowed Beijing would “act strongly” and “take countermeasures” in response to a Pelosi visit.

White House officials said Friday they saw no evidence China’s military was preparing major action against Taiwan.

China announced Saturday it was holding “live-fire” military exercises off its coast facing Taiwan. The drills, which were set to last from 8 a.m.-9 p.m. local time, occurred near the Pingtan islands off Fujian province, according to China’s official Xinhua news agency. The report did not specify what type of weapons were used in the exercises.

On Sunday, a spokesperson for China’s air force said Beijing has the “firm will” and “sufficient capability to defend national sovereignty and territorial integrity.” The spokesperson, who was quoted in state media, also said China had various fighter jets that can circle “the precious island of our motherland.”

China has flown an increasing number of warplanes through Taiwan’s self-declared air defense identification zone in recent years, greatly raising tensions in the Taiwan Strait. In recent weeks, Chinese state media editorials have warned Chinese fighter jets could follow and intercept Pelosi’s plane.

Hu Xijin, a fiercely nationalistic commentator for the Communist Party’s Global Times, even suggested in a tweet that the Chinese military has the right to “forcibly dispel” any U.S. aircraft traveling or escorting Pelosi to Taiwan.

“If ineffective, then shoot them down,” Hu said in the tweet, which was later removed because it violated Twitter guidelines.

Despite China’s warnings, a large, bipartisan chorus of lawmakers had urged Pelosi to not back down, saying China should not be allowed to dictate where U.S. officials visit.

“It would make it look like America can be shoved around,” former House Speaker Gingrich told VOA’s Mandarin Service earlier this week. Gingrich said he supports Pelosi’s trip, which will likely only amount to “an irritation” to U.S.-China ties.

“I think this is at one level a lot of noise about nothing,” Gingrich said. “I think if she holds her ground, and if the Biden administration doesn’t act timidly and almost cowardly, I think everything will be fine.”

Taiwan is one of the most dangerous points of tension in an increasingly fraught U.S.-China relationship.

The United States formally cut official relations with Taiwan in 1979 when it switched diplomatic recognition to China. However, the United States has continued to supply Taiwan with defensive weapons as mandated by the U.S. Congress.

U.S. presidents have long used a policy of “strategic ambiguity” toward Taiwan – essentially leaving their options open in the case of a Chinese invasion of the island.

However, Biden’s recent comments have raised doubts about that approach. Since taking office, Biden on three occasions has said the U.S. is committed to defending Taiwan.

Biden has been cautious, though, on the prospect of a Pelosi visit. Earlier this month, Biden said the U.S. military does not think a visit would be a good idea.

Pelosi’s possible visit comes at a sensitive moment for Xi, who is expected to use a Communist Party Congress later this year to secure a controversial third term as China’s top leader.

Observers have said Xi, China’s most powerful leader in decades, may want to send a tough message on Taiwan ahead of the meeting. But he may also want to preserve stability around a sensitive political moment.

White House National Security Council spokesperson John Kirby said Friday there is “no reason” for increased tension with China because U.S. policy has not changed.

Kirby reiterated that Pelosi “does not need nor do we offer approval or disapproval” for travel. He added: “The speaker is entitled to travel aboard a military aircraft.”

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In US, Abortion Laws Differ Across the Street  

The bedsheets are big. Some are light pink, others hot pink or purple, connected and stretched taut by people holding wooden poles. Together, the sheets form a barrier across the parking lot. The activists, who are supporting a woman’s right to an abortion, wear bright pink vests with PRO-CHOICE in black emblazoned on the front.

This is the front line of protection for pregnant women who drive to this women’s center for an abortion. The sheeting forms a tunnel for them to leave their cars and enter the center, unseen by anti-abortion protesters trying to stop them.

‘There’s very little conversation’

This is the daily scene at the Bristol Regional Women’s Center.   The abortion-rights activists stay inside the center parking lot; the anti-abortion protesters stand on the sidewalk. They walk next to a busy street with posters reading “Love Your Baby and Yourself” or “Babies are Murdered Here” next to competing pink signs that read, “Honk Twice for Choice.”

A local church organizes the anti-abortion protesters. Natalie, who asked to use only her first name for safety reasons, is 24. She has been coming here weekly for seven years, saying, “This is what the Lord has called us to do.” She says  no patient has ever approached her for help.

Another young protester, Haven, says he’s handed out a few pamphlets but it is difficult to approach the women because of the sheeting. He has not spoken to the doctors or the abortion-rights protesters, adding, “There’s very little conversation that can happen.”

The abortion-rights protesters chose not to speak to VOA about their views and asked us to leave. One shone a flashlight into the lens of our video camera.

Inside the clinic, women are given an ultrasound on the first visit. If no fetal heartbeat is detected, they return for a second ultrasound in 48 hours. Again, if no cardiac activity is heard, they are given counseling before a medical abortion.

That is not the case in the adjacent state.

Legal and illegal separated by a street

Bristol, Tennessee, is a border town.

The state line is marked by numerous 20-centimeter-long brass plaques that run down the center of State Street, separating Tennessee from Virginia and its different laws.

As soon as the U.S. Supreme Court in June struck down abortion as a constitutional right, some states instituted “trigger laws” outlawing some or all abortions.

Tennessee’s trigger law outlawed surgical abortions and allowed medical abortions, which use medication to end a pregnancy, during the first six weeks of a pregnancy or until a heartbeat can be recognized, which typically occurs near that time limit.

That means abortions remain legal in Virginia but across State Street, they are restricted in Tennessee.

Olivia, who prefers to use only her first name for safety reasons, is a medical assistant at a women’s clinic in Bristol, Tennessee. She says in the past month, her clinic has had to turn away women in tears, some who had driven many hours to reach the clinic, because an ultrasound found fetal heart activity. The office refers them to Virginia offices if they live nearby. But some drive from eastern Tennessee, and a delay of an extra day to reach another state that’s closer than Virginia can affect the legality of an abortion.

“It becomes a bigger issue,” Olivia says, giving as an example, “North Carolina, [where] you have two separate visits with a 72-hour waiting period.”

Star Eans is a makeup artist on TikTok. The U.S. Supreme Court decision motivated her to become a abortion-rights activist. Eans had a medical abortion less than a year ago when she lived in Tennessee, and complications required a surgical abortion.

“It just makes me angry thinking that, like, if that had happened this year, I would have just died,” Eans says. “If I was still living in Tennessee, and I had to have this baby that I didn’t want, I was very much on the verge of ending myself.”

Doctor looks to move across the border

On Aug. 25, another Tennessee law will prohibit all abortions, surgical and medical.

Because of that, the doctor who runs the Bristol women’s center is considering a satellite office less than a mile away where abortions are legal in Bristol, Virginia.  A GoFundMe page has raised more than $100,000 for the new clinic, and an update on July 29 said it had opened.

But anti-abortion protesters held a rally earlier in July at the Virginia clinic and alerted residents, including Emmitt Russell, whose house is next door. He objects to the anti-abortion protesters and the clinic and says a Virginia ban would motivate him to the polls.

“I didn’t vote in the last two presidential elections … but I would vote against abortions in Virginia, yes,” he said.

No trigger laws exist in Virginia. But Republican Governor Glenn Youngkin is supporting making abortions illegal after 15 weeks. Republicans hold a majority in the state House and could support a ban, but experts think it would be defeated in the Democrat-controlled Senate.  

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Action on Monkeypox Accelerates in US as Outbreak Expands 

Two of the hardest-hit U.S. regions have raised the alert level over the monkeypox outbreak.

San Francisco declared a public health emergency Thursday. The city accounts for 281 of California’s nearly 800 cases. The declaration gives health officials access to additional resources to deal with the outbreak.

New York, with nearly 1,400 cases statewide, made a similar declaration Thursday.

Worldwide, more than 21,000 cases have been reported in 78 countries, nearly all of them outside West and Central Africa, where the virus is endemic. The World Health Organization (WHO) raised the threat level to its highest ranking last weekend.

The U.S. case count is nearing 5,000, according to the U.S. Centers for Disease Control and Prevention (CDC).

The federal government has not declared an emergency but announced plans Thursday to distribute nearly 800,000 additional doses of monkeypox vaccine.

U.S. health officials said they had already distributed 340,000 doses, but many jurisdictions have reported that they have had to turn away patients because of short supplies.

Here are some answers to frequently asked questions.

Who gets monkeypox, and how?

The outbreak has been concentrated among men who have sex with men, though anyone can get monkeypox.

The virus spreads through contact with the rash that infected patients develop. It can also pass through bodily fluids, respiratory droplets after prolonged face-to-face contact or contaminated clothing, bedding or towels.

Men who have sex with men should have fewer sex partners in order to curb the spread, WHO chief Tedros Adhanom Ghebreyesus said Wednesday.

“This is an outbreak that can be stopped,” Tedros said. “The best way to do that is to reduce the risk of exposure.”

However, he added, intolerance of homosexuality would not help.

“Stigma and discrimination can be as dangerous as any virus, and can fuel the outbreak,” Tedros said.

What are the symptoms? Is it fatal?

The disease causes fever, headache, muscle pain, fatigue and swollen lymph nodes, followed by a rash, usually on the face, palms and soles of the feet. About a third of cases also develop a rash on the genitals.

The strain of monkeypox responsible for the global outbreak is rarely fatal but can be extremely painful, according to the CDC. About 10% of cases have been hospitalized “to manage the pain caused by the disease,” Tedros said.

Five deaths have been reported — three in Nigeria and two in the Central African Republic.

What about vaccines and treatments?

About 16 million doses of vaccine are available worldwide, but most will take several months to be packaged and distributed, according to the WHO, which is recommending vaccination only for people at high risk, including people exposed to an infected person, health workers and people with multiple sex partners.

People vaccinated against smallpox likely have some protection against monkeypox, which is a related virus. Smallpox vaccination ended after the disease was declared eradicated in 1980.

Several antiviral medications have been approved.

How unusual is this outbreak?

The current outbreak is the first time this many cases have occurred in such widely dispersed areas outside the endemic countries in West and Central Africa.

Europe accounts for two-thirds of the cases. Nearly one-fifth are in the United States.

WHO’s advisory committee did not agree on the magnitude of the threat at its meeting last Saturday, but Tedros made the decision to declare a “public health emergency of international concern,” the agency’s highest threat assessment.

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Top US Diplomat Travels to Asia, Africa as Global Powers Fight for Influence

U.S. Secretary of State Antony Blinken travels to East Asia and Africa next week seeking to counter the influence of Russia and China in a fight for global influence.

Blinken begins his travels Tuesday on a tour that will take him to Cambodia, the Philippines, South Africa, the Democratic Republic of the Congo and Rwanda.

During his first stop in Cambodia, he will attend a Southeast Asian regional security forum where both the Russian and Chinese foreign ministers are expected to be in attendance.

When asked if Blinken would hold direct meetings with either Russian Foreign Minister Sergey Lavrov or Chinese Foreign Minister Wang Yi, Assistant Secretary of State for East Asia and Pacific Affairs Daniel Kritenbrink said there were no plans for formal meetings at this time.

During a briefing with reporters about Blinken’s trip, Kritenbrink did not rule out the possibility of an informal conversation between Blinken and Wang on the sidelines of the Association of Southeast Asian Nations Regional Forum in Cambodia.

Blinken spoke to Lavrov on Friday in the first conversation between the high-level officials since Russia’s invasion of Ukraine in late February. Blinken pressed Lavrov to accept a U.S. proposal to secure the release of two Americans detained in Russia —professional basketball star Brittney Griner and former U.S. Marine Paul Whelan.

The State Department said in a statement Friday that Blinken will address the COVID-19 pandemic, climate change, Myanmar and the war in Ukraine during the ASEAN ministers meeting.

Kritenbrink said Blinken would urge Asian nations to increase pressure on Myanmar after its government executed four activists this week.

“This is just the latest example of the regime’s brutality,” he said.

While in the Philippines, the secretary’s next stop, Kritenbrink said Blinken would reaffirm the U.S. commitment to the two countries’ mutual defense treaty, which he called “ironclad.”

Blinken then travels to Africa, part of an increased U.S. diplomatic effort in the region that follows Russia’s outreach to the continent.

USAID chief Samantha Power recently visited Kenya and Somalia, and U.S. Ambassador to the United Nations Linda Thomas-Greenfield is planning to travel next month to Ghana and Uganda.

The visit by Blinken is part of the U.S. view that “African countries are geostrategic players and critical partners on the most pressing issues of our day,” according to a State Department release.

Each of the African countries Blinken is visiting — South Africa, the Democratic Republic of the Congo and Rwanda — is a “significant player on the continent and on the globe,” according to Assistant Secretary of State for African Affairs Molly Phee.

She told reporters Friday the secretary will deliver a speech on U.S. strategy toward sub-Saharan Africa while in South Africa.

Russia’s war in Ukraine is expected to be a major focus during Blinken’s stops in Africa.

Russia’s Lavrov this week wrapped up a tour of four African nations to strengthen ties with the continent and seek support against Western pressure over Moscow’s invasion of Ukraine.

Most African nations have remained neutral on the Ukraine war, despite pressure from Washington to condemn Russia’s invasion.

During his visit to the continent, Lavrov praised African nations for their independence.

Climate change will be another important topic during Blinken’s tour of Africa, according to Phee, who said the secretary would press Congo on its plan to reopen its rain forest to commercial logging.

While in Rwanda, Blinken will raise the “wrongful detention” of U.S. permanent resident Paul Rusesabagina, according to the State Department. Rusesabagina’s actions saved hundreds of lives during the 1994 genocide and inspired the movie Hotel Rwanda.

“We’ve been very clear with the government of Rwanda about our concerns about his case, his trial and his conviction, particularly the lack of fair trial guarantees in his case,” Phee said.

She said Blinken would also work to ease tensions between Congo and Rwanda. Congo has accused its neighbor of backing M23 rebels, a charge Kigali denies.

Some information in this report came from The Associated Press, Reuters, and Agence France-Presse.

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