SA researcher makes top 100 LBGTQI+ influencer list for monkeypox work

It was a happy accident of circumstances that saw Harvard University fellow Dr Keletso Makofane, 35, perfectly placed to co-ordinate a response platform and research hub when the monkeypox (MPV) epidemic hit the US earlier this year.

The achievements the young South African racked up in a few months of accessing information, examining infection rates and patterns and addressing access to healthcare and vaccines has won him a place in Out Magazine’s 2022 Out100 list of LGBTQI+ policymakers and advocates changing the world.

The list was announced on October 28. The publication is the largest American LGBTQ news, fashion, entertainment and lifestyle magazine. It describes Makofane as one of the “leading figures” in working to stop the spread of monkeypox.

This year has seen a record number of US bills from conservative lawmakers attacking the gay and transgender communities, with the MPV outbreak causing new stigma and misinformation.

A public health researcher and activist at the François-Xavier Bagnoud Center for Health and Human Rights at Harvard University, Makofane’s main focus has been the global response to HIV among sexual minority men in Eastern and Southern Africa. But this year, he pivoted to MPV.

“I am a postdoctoral fellow involved in research that has a crossover with activism and fits well with the policy intervention work I do,” Makofane, who is at present in South Africa, told The Sunday Times.

He grew up in Bloemfontein, where his retired parents live, and went to St Andrew’s School.

Makofane moved to the US in 2017 to do a doctorate in epidemiology at Harvard. He had been doing work in the HIV field for more than a decade and living in New York when MPV infections started showing up there.

Monkeypox is a zoonotic virus related to smallpox and has been endemic in Central and West Africa since the 1990s. Makofane said that in 2017 there was a shift in infection patterns when it started transmitting from human to human in Nigeria.

The virus causes lesions to erupt all over the body. There is a vaccine, treatments have been found and it passes after about four weeks. The death rate is extremely low.

“In May we started seeing cases in Western Europe that were linked to big sex parties. Those infected were mostly gay men. It was moving quickly and there was hope it would dissipate because we knew human-to-human transmission was rare,” Makofane said.

Soon after that, infections were reported in the US and began spreading rapidly.

“It was Pride season, so there were huge gatherings in big cities. That accelerated the transmission of pathogens. We tried to mobilise vaccines to cover that population pre-emptively,” he said.

“We started to look at sex networks and how they were connecting so we could work out how to hit transmission hubs. But government was slow to respond and it grew into an enormous problem — something like the early days of Aids. We were now dealing with an illness presenting in ways we couldn’t quite understand.

“It is a serious illness, but the approach has been laissez-faire because it’s not lethal,” Makofane said. 

Despite the lessons and experiences of the Aids and Covid-19 pandemics, Makofane said the system proved to be “inadequate at every level and exposed our inability to respond well to an infection outbreak”.

“Clinicians at LGBT clinics began reporting that patients were not being treated by mainstream doctors for anything monkeypox-related. They were being turfed out and sent to underfunded health providers. It was cruel. They were not being treated for their extreme pain.

And so he approached government and lobbied for funding, started creating communication platforms and networked.

What was planned as a one-month survey has developed into a bigger project looking at access to vaccines and treatment, the stream of infections crossing borders, collaborations with the World Health Organisation and global policymakers and tracking the virus.

“It looks as though it is on the decline. But we suspect that may not be the case and it is spreading in vulnerable and marginalised communities reliant on public health infrastructure that is failing them, and where infection numbers are inaccurate or unknown.”

Makofane’s efforts have gained him global recognition as a prominent influencer changing the world.

He said of making the Out100 list: “It’s a great acknowledgement for an ambitious project and I am thrilled to be included in such an interesting and diverse collection of people.”