Why the World Health Organization Renaming "Monkeypox" Is Unnecessary

Earlier this week, the World Health Organization (WHO) made an announcement that it going to change the name of the disease "monkeypox" to "mpox." For those who do not know, the monkeypox virus is a viral zoonosis similar to smallpox. Symptoms include fever, muscle pains, lesions, and swollen glands. While the fatality rate for the 2022 outbreak has been less than 1 percent, it is nevertheless an unpleasant two to four weeks for those who contract the disease. 

WHO's renaming decision was made out of concern of racism and stigmatization, particularly towards African nations. In August, the LA Times stated that experts were concerned that keeping the name "monkeypox" could "discourage patients from seeking treatment, cause people to shun those who are infected, and reinforce racist tropes." It might seem well-intentioned to select a name that is not offensive, but the name change was ultimately unnecessary.

It has been common practice to name a new disease or virus based on the details of its discovery or siting of the first outbreak, such as the place of origin or the animal in which the disease was first discovered:

• The West Nile Virus was first discovered in 1937 in the West Nile district in Uganda. 
• Lyme disease was discovered in 1975 in the rural area of Lyme, Connecticut. 
• Ebola was first discovered in 1976 near the Ebola River. 
• In 1896, Rocky Mountain Spotted Fever was named for the mountain range where it was found.
• Zika was discovered in 1946 in the Zika Forest in Uganda. 
• Swine flu was named as such because it originated in pigs. A similar story with mad cow disease. 

What about monkeypox? According to Smithsonian Magazine, monkeypox was first identified in 1958 in a colony of monkeys in a laboratory in Copenhagen, Denmark. One could categorize "monkeypox" as a misnomer because monkeys were not the reservoir; they were the first animal seen afflicted with the disease. Nevertheless, monkeypox was named in a non-racist fashion that has precedent. On the other hand, maybe in a world so interconnected where borders matter less for traveling microbes, perhaps such a practice of naming a virus after the place of origin is antiquated.

Regardless of whether such a practice is indeed passé, what about the racist charges? There is nothing in the name "monkeypox" that explicitly implicates Africans in the disease or its outbreak. Yes, it is true that there is an unfortunate and egregious history of comparing Black people to primates, especially in the 19th and 20th centuries. 

Even such media outlets as the New York Times that are bemoaning the historic racism cannot provide a notable example of the vile comparison being evoked in the context of this latest outbreak. As for the criticism of photos of black people being used early in the outbreak? That was because prior to this latest outbreak, almost all cases of monkeypox occurred in Africa, which means that those were the photos most readily available.  

I would like to bring up the theme of how prominent the disease is. As recently mentioned, the disease has most prominently shown up in various parts of Africa for years now. Only in recent months has it made its way to the developed world. I bring up prevalence of monkeypox because some argued early on in the outbreak that calling it "monkeypox" could "create barriers for those seeking care." 

As of November 28, there have been about 81,188 confirmed cases worldwide (CDC). For an outbreak that has been ongoing since May 2022, that is not a lot of cases on a global level, especially when compared to the millions of COVID cases. As we see from WHO data, the number of cases has been on the decline. It is possible for cases to rise or fall. However, at this time, the number of cases is quite low. That could be due to vaccination, a lower transmission rate, the fact that monkeypox only gets transmitted under specific circumstances, or a combination thereof. Whatever the case, it makes me wonder why WHO bothered to make this renaming decision. You think the WHO would have better things to do than decide the name of a rare disease that is waning in prevalence. 

A bit of a tangent: one argument against the name is that it does not convey useful information because "it suggests that infects monkeys." Do people think that chickenpox only affects chickens? What about the swine flu? Do people think swine flu cannot be transmitted among humans because of the name? 

I want to get at the most salient point to make. How much will calling the disease "mpox" actually help? If you read the press release from the WHO, the word "monkeypox" will still be used for another year alongside of "mpox" until "monkeypox" is phased out. How does that help in the short-term? Another point is that the monkey attribution really does not go away. Most people are going to know what the "m" in "mpox" stands for. 

Furthermore, we have been down this road before. In 1982, the disease now known as AIDS was initially known as gay-related immune deficiency (GRID). Did a name change from GRID to HIV remove stigma against gay men since 1982? I think we know the answer to that question. Certain stigmas will exist in spite of name changes. In 2020, the WHO changed the name of our most recent pandemic to COVID. It was deemed inoffensive in comparison to the "Wuhan Virus" that had anti-Asian implications. Yet it is still possible to call someone a Covidian or a Covidiot.  

There is also a practical issue to consider. "Monkeypox" has been the name used in scientific literature for over half a century. Do you think a name change is appropriate in the middle of an outbreak when scientists need access to the literature to make sure they can research the virus and develop treatments or improve upon monkeypox testing? 

Do you know what would be more helpful than a name change? Let's ask Kelesto Makofane, a gay African public health researcher at Harvard. According to Makofane, the name is not the issue. In August, he said that "The things that are really standing in the way of a successful response are just having access to testing, to vaccines, and to treatments." The AIDS Health Foundation made a similar argument. 

Multiple studies confirm that this outbreak is almost exclusively men who have sex with men (MSM). Rather than focus on a name change, the AIDS Health Foundation calls on the WHO to focus on what will help MSM the most and mitigate the stigma of gay and bisexual men: education, prevention, testing, treatment, and research. Given the context outlined today, changing the name is nonsensical. Missing the forest for the trees is not a success. Regardless of what the WHO decides to call this virus, evidence-based public health measures are going to make a bigger difference than a feel-good name change.