The WHO Director-General has declared the Mpox outbreak a public health emergency of international concern.
Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, has declared the outbreak of mpox in the Democratic Republic of the Congo (DRC) and a growing number of African countries to be a public health emergency of international concern (PHEIC) under the International Health Regulations (2005).
Dr. Tedros’ proclamation followed the suggestion of an IHR Emergency Committee of independent experts, who met earlier in the day to assess data submitted by WHO and affected country experts. The Committee told the Director-General that it considered the mpox outbreak to be a PHEIC, with the potential to spread across African countries and even beyond the continent.
The Director-General will distribute the Committee’s meeting report and, based on the Committee’s guidance, make temporary recommendations to governments.
In declaring the PHEIC, Dr Tedros stated, “The discovery of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in multiple neighboring countries are quite concerning. In addition to outbreaks of additional mpox clades in the Democratic Republic of the Congo and other African countries, it is evident that a coordinated international response is required to end these epidemics and save lives.”
Dr Matshidiso Moeti, WHO Regional Director for Africa, stated, “Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the front lines to help reinforce measures to combat mpox.” With the virus’s growth, we’re ramping up even more through coordinated worldwide action to help countries halt outbreaks.”
Committee Chair Professor Dimie Ogoina stated, “The current outbreak of mpox in parts of Africa, combined with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire world.” Mpox, which originated in Africa, was neglected until it caused a global outbreak in 2022. It is necessary to take serious action to avoid history from repeating itself.”
This is the second PHEIC determination in two years for mpox. Mpopox, which is caused by an orthopoxvirus, was first discovered in people in the Democratic Republic of the Congo in 1970. The disease is considered endemic throughout central and western Africa.
In July 2022, the multi-country mpox epidemic was classified a PHEIC due to its rapid spread via sexual contact across a number of countries where the virus had never been encountered. The PHEIC was declared over in May 2023, following a persistent drop in global cases.
Mpox has been recorded in the DRC for almost a decade, and the number of cases reported each year has consistently climbed throughout that time. previous year, reported cases grew dramatically, and the number of cases reported this year has already surpassed previous year’s total, with almost 15,600 cases and 537 deaths.
The development and rapid dissemination of a novel virus strain in the Democratic Republic of the Congo, clade 1b, which appears to be spreading mostly through sexual networks, as well as its detection in neighboring countries, is particularly worrying and one of the key reasons for the PHEIC announcement.
Over 100 laboratory-confirmed cases of clade 1b have been identified in four countries bordering the Democratic Republic of the Congo that had not previously reported mpox: Burundi, Kenya, Rwanda, and Uganda. Experts believe the true number of cases is larger because a significant proportion of clinically compatible cases have not been examined.
Several outbreaks of different mpox clades have occurred in various countries, each with its own mode of transmission and level of danger.
The two vaccines currently used for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization and have been licensed by WHO-listed national regulatory authorities as well as specific nations such as Nigeria and the Democratic Republic of the Congo.
Last Monday, the Director-General initiated the process of Emergency Use Listing for mpox vaccinations, which will speed up vaccine access in low-income countries that have yet to issue their own national regulatory approval. Emergency Use Listing also allows partners like Gavi and UNICEF to obtain vaccines for distribution.
WHO is collaborating with governments and vaccine producers on prospective vaccine contributions and cooperating with partners via the interim Medical Countermeasures Network to ensure fair access to vaccines, medicines, diagnostics, and other instruments.
WHO predicts an immediate budget requirement of $15 million to support surveillance, preparedness, and response actions. A needs assessment is being conducted at all three levels of the organization.
To allow for an urgent scale-up, WHO has issued $1.45 million from the WHO Contingency Fund for Emergencies, and more may be required in the coming days. The organization asks contributors to cover the entire scope of the mpox response.
