WHO Director-General Dr. Tedros Adhanom Ghebreyesus has officially classified the recent surge of monkeypox or mpox cases in the Democratic Republic of the Congo (DRC) and several other African nations as a public health emergency of international concern (PHEIC), as per the International Health Regulations (2005).
This declaration was made following recommendations from an IHR Emergency Committee composed of independent experts who convened earlier to analyse data from WHO and affected nations. The committee advised that the mpox outbreak poses a significant risk of further spread across Africa and potentially beyond.
Dr. Tedros is set to release the committee’s report and will provide temporary recommendations to countries based on their guidance.
In his announcement, Dr. Tedros expressed alarm over the emergence of a new clade of mpox, its rapid transmission in eastern DRC, and the detection of cases in neighbouring countries. He emphasised the urgent need for a coordinated international response to manage these outbreaks and protect lives.
Dr. Matshidiso Moeti, WHO regional director for Africa, highlighted ongoing efforts in collaboration with communities and governments, stating that frontline teams are enhancing measures to control mpox. With the virus’s increasing spread, there will be a further escalation of coordinated international actions to help countries end these outbreaks.
Professor Dimie Ogoina, chair of the committee, remarked that the current mpox surge in Africa, alongside the emergence of a new sexually transmissible strain, represents a global emergency. He noted that mpox, which originated in Africa, was overlooked and subsequently led to a worldwide outbreak in 2022, stressing the need for decisive action to avert a recurrence.
Background
This is the second PHEIC declaration regarding mpox in two years. The disease, caused by an Orthopoxvirus, was first identified in humans in the DRC in 1970 and is endemic in central and west Africa.
In July 2022, a multi-country mpox outbreak was declared a PHEIC as it spread rapidly through sexual contact in regions where the virus had previously been absent. That emergency was lifted in May 2023 due to a sustained decline in cases.
Over the past decade, mpox cases in the DRC have steadily increased, with a significant rise last year. So far this year, reported cases have surpassed last year’s total, with over 15,600 cases and 537 deaths.
Recent Developments
The emergence of a new strain, clade 1b, which appears to spread primarily through sexual networks, has raised particular concern, especially following its detection in neighbouring countries. In the past month, over 100 confirmed cases of clade 1b have emerged in Burundi, Kenya, Rwanda, and Uganda—countries that had not reported mpox cases before. Experts believe the actual number of cases is likely higher due to under-testing.
Multiple outbreaks of various mpox clades are occurring across different nations, each with distinct transmission methods and risk levels. WHO recommends two vaccines for mpox, which have been approved by national regulatory authorities and are endorsed by the Strategic Advisory Group of Experts on Immunization.
Recently, the director-general initiated the Emergency Use Listing process for mpox vaccines to facilitate quicker access for lower-income countries lacking national approvals. This process also enables partners like Gavi and UNICEF to procure and distribute vaccines.
Funding and Support Needs
WHO is collaborating with countries and vaccine manufacturers for potential vaccine donations and is coordinating efforts through the interim Medical Countermeasures Network to ensure equitable access to vaccines, therapeutics, diagnostics, and other resources.
An immediate funding requirement of $15 million has been identified to support surveillance, preparedness, and response activities, with an ongoing needs assessment across the organisation.
To expedite response efforts, WHO has allocated $1.45 million from its Contingency Fund for Emergencies and may release additional funds as necessary. The organisation is appealing to donors to fully support the mpox response needs.