China is fuelling a global surge in mpox cases, accounting for the majority of new cases reported in September, according to the World Health Organization.
The number of weekly cases reported globally increased by 328% in the week to 10 September, data shows. Most of that rise came from China, where more than 500 new cases were reported in August. The WHO said China was experiencing “sustained community transmission” of the virus, which was first detected as an imported case in September last year.
Mpox was previously known as Monkeypox but renamed by the WHO in 2022 in an effort to help tackle discrimination and stigma.
In July, the Chinese Center for Disease Control and Prevention reported for the first time that the disease was spreading domestically, with 106 cases recorded in June. Since then cases have surged by nearly 400%, with the true number of infections thought to be much higher than the official count.
Five women tested positive for the disease in August, leading to concerns that the virus, which has predominantly been found among men who have sex with men, is spreading more widely.
On Wednesday, the Chinese government started treating mpox under the same protocols as Covid-19, meaning that the authorities can take emergency measures such as restricting gatherings to curb the spread of the disease.
The majority of mpox cases since 2022 have been in men who have sex with menand 92.5% of cases in August were among that demographic. But in recent years the pressure on LGBTQ+ activists in China has increased, limiting their ability to advocate and increasing the social stigmatisation of LGBTQ+ people.
Experts believe that this could make people less likely to get tested. Vaccinations are not available in mainland China, although state media reported that a domestic vaccine is being developed. “Public health concerns are one of the only ways of discussing gay men in public discourse,” said Chuncheng Liu, a medical sociologist. “[But] you cannot rely on scaring people to come to you for help.”
In August, several accounts on the messaging app WeChat dedicated to gay, trans and feminist issues were closed down without explanation. In May, the Beijing LGBT Center, one of China’s best known LGBTQ+ advocacy groups, closed down for undisclosed reasons. It had been one of the last active civil society groups after LGBT Rights Advocacy China, another influential NGO, closed in 2021.
The closures had a “huge influence for the community”, said one LGBTQ+ activist, who left China in recent years because of pressure from the authorities, “because it says that the government is still trying to target them”.
While the Chinese Center for Disease Control and Prevention has been publishing reports about mpox, and there is uncensored information on social media about recognising symptoms, Liu noted that LGBTQ+ people might not be following those accounts. “The problem is not about information or about a specific message,” Liu said. It is about how to “circulate this message to the community”.
A report published in September by Outright International, a New York-based LGBTQ+ rights organisation, said activists in China were “increasingly restricted” by the government. One anonymous activist said police had encouraged them to “just focus on providing services like HIV prevention and care”, while groups that mention the words “lesbian, gay, bisexual, transgender and queer” are often refused official registration.
Many LGBTQ+ groups started out with a focus on HIV/Aids awareness, making their case to the authorities on the grounds of public health rather than political rights.
In the early 2010s, as HIV/Aids prevention and treatment became more established in China, support from international donors such as the Global Fund and the Bill and Melinda Gates Foundation, started to dry up. And in 2016, Beijing passed a foreign NGO law that restricted the ability of domestic groups to work with foreign organisations or receive international funding.
Additional research by Tau Yang and Tzu-Wei Liu
China inaongeza idadi ya visa vya ugonjwa wa mpox duniani, ikitoa asilimia kubwa ya visa vipya vilivyoripotiwa mwezi Septemba, kulingana na Shirika la Afya Duniani (WHO). Idadi ya kesi za kila wiki zilizoripotiwa ulimwenguni kote iliongezeka kwa 328% katika wiki hadi Septemba 10, data zinaonyesha. Ongezeko hilo la maambukizi lilitokana na China, ambapo zaidi ya visa vipya 500 viliripotiwa mwezi Agosti. WHO imesema China inaendelea na "kuambukizwa kwa jamii" kwa virusi hivyo, ambavyo viligunduliwa kwa mara ya kwanza kama kesi ya kuingizwa nchini China mwezi Septemba mwaka jana. Mpox ilijulikana kama Monkeypox lakini ilibadilishwa jina na WHO mnamo 2022 katika juhudi za kusaidia kukabiliana na ubaguzi na chuki. Kituo cha China cha Kudhibiti na Kuzuia Magonjwa kiliripoti kwa mara ya kwanza kwamba ugonjwa huo unaenea ndani ya nchi, na visa 106 vilirekodiwa mwezi Juni. Tangu wakati huo, visa vimeongezeka kwa karibu 400%, na idadi halisi ya maambukizi inadhaniwa kuwa kubwa zaidi kuliko hesabu rasmi. Wanawake watano walipatikana na virusi hivyo mwezi Agosti, na kusababisha wasiwasi kwamba virusi hivyo, ambavyo vimepatikana hasa miongoni mwa wanaume wanaofanya ngono na wanaume, vinaenea kwa wingi. Serikali ya China ilianza kutibu ugonjwa wa mpox chini ya itifaki sawa na COVID-19, ikimaanisha kuwa mamlaka zinaweza kuchukua hatua za dharura kama vile kuzuia makusanyiko ili kuzuia kuenea kwa ugonjwa huo. Katika kesi nyingi za Mpox tangu mwaka wa 2022, wanaume wanaofanya ngono na wanaume ndio walioambukizwa na ugonjwa huo, na asilimia 92.5 ya visa vilivyoambukizwa mwezi Agosti ni miongoni mwa watu hao. Lakini katika miaka ya hivi karibuni shinikizo juu ya wanaharakati wa LGBTQ + nchini China limeongezeka, ikipunguza uwezo wao wa kutetea na kuongeza utambuzi wa kijamii wa watu wa LGBTQ +. Wataalamu wanaamini kwamba hii inaweza kufanya watu wawe na uwezekano mdogo wa kupimwa. Chanjo hiyo haipatikani nchini China, ingawa vyombo vya habari vya serikali vimeripoti kuwa chanjo ya ndani inaendelezwa. "Mahangaiko ya afya ya umma ni mojawapo ya njia pekee za kujadili wanaume mashoga katika mazungumzo ya umma", alisema Chuncheng Liu, mwanasosholojia wa matibabu. "Lakini, ""huwezi kutegemea kuwaogopesha watu ili wakuja kwako kwa msaada"" Agosti, akaunti kadhaa kwenye programu ya ujumbe wa WeChat iliyojitolea kwa masuala ya mashoga, trans na wanawake zilifungwa bila ufafanuzi." Kituo cha Beijing cha LGBT, moja ya makundi maarufu zaidi ya utetezi wa LGBTQ + nchini China, imefungwa kwa sababu zisizojulikana. Ilikuwa ni moja ya makundi ya mwisho ya jamii ya kiraia baada ya LGBT Rights Advocacy China, shirika jingine lenye ushawishi, kufungwa mnamo 2021. "Ufungwaji huo ulikuwa na ""ushawishi mkubwa kwa jamii,"" alisema mwanaharakati mmoja wa LGBTQ+ ambaye aliondoka China katika miaka ya hivi karibuni kwa sababu ya shinikizo kutoka kwa mamlaka, ""kwa sababu inasema kwamba serikali bado inajaribu kuwashambulia.""" Wakati Kituo cha Udhibiti na Kuzuia Magonjwa cha China kimechapisha ripoti kuhusu mpox, na kuna habari isiyo na udhibiti kwenye media ya kijamii juu ya kutambua dalili, Liu alisema kuwa watu wa LGBTQ + wanaweza kuwa hawafuati akaunti hizo. "Tatizo si kuhusu habari au kuhusu ujumbe maalum", Liu alisema. Ni kuhusu jinsi ya <unk>kueneza ujumbe huu kwa jamii<unk>. Ripoti ya Outright International, shirika la haki za watu wa jinsia moja, ilisema wanaharakati nchini China wanazidi kukandamizwa na serikali. Mwanaharakati mmoja aliyetaka kutangaza jina lake alisema polisi waliwatia moyo "kuzingatia tu kutoa huduma kama vile kuzuia na kutunza virusi vya Ukimwi", wakati vikundi vinavyotaja maneno "wasagaji, mashoga, wagoni-jinsia-moja, watu wa jinsia tofauti na watu wa jinsia tofauti" mara nyingi hukataliwa usajili rasmi. Vikundi vingi vya LGBTQ+ vilianza kwa kuzingatia ufahamu wa UKIMWI, na kufanya kesi yao kwa mamlaka kwa misingi ya afya ya umma badala ya haki za kisiasa. Katika miaka ya mapema ya 2010, wakati kuzuia na kutibu virusi vya Ukimwi vilianza kuanzishwa nchini China, msaada kutoka kwa wafadhili wa kimataifa kama vile Mfuko wa Ulimwenguni na Bill na Melinda Gates Foundation ulianza kufifia. Mwaka 2016, Beijing ilipitisha sheria ya mashirika yasiyo ya kiserikali ya kigeni ambayo ilizuia uwezo wa makundi ya ndani kufanya kazi na mashirika ya kigeni au kupokea fedha za kimataifa. Utafiti wa ziada na Tau Yang na Tzu-Wei Liu