WHO Declares Mpox a Global Health Emergency

The World Health Organization (WHO) has officially declared the ongoing mpox outbreak in Africa a global health emergency.

This decision, made on Wednesday, comes amid growing concerns that a more virulent strain of the virus, known as clade Ib, has begun to spread to countries in Africa that had not previously reported cases. Until recently, this strain was mostly confined to the Democratic Republic of Congo (DRC), but its recent detection in four new African countries has sparked alarm.

The WHO convened its emergency committee to assess the situation, and after careful consideration, WHO Director-General Tedros Adhanom Ghebreyesus declared the outbreak a public health emergency of international concern (PHEIC)—the highest level of alert under international health regulations. “The detection and rapid spread of a new clade of mpox in eastern DRC, its spread to neighboring countries, and the potential for further expansion within Africa and beyond is very concerning,” Ghebreyesus stated. “The emergency committee met and advised me that the situation constitutes a public health emergency of international concern. I have accepted that advice.”

This designation of PHEIC is significant, as it is reserved for extraordinary events that pose a public health risk through the international spread of disease and may necessitate a coordinated international response. The WHO committee, chaired by Dimie Ogoina, was unanimous in its assessment that the current outbreak is an extraordinary event requiring immediate global attention. Ogoina noted that the situation in Africa might only be the "tip of the iceberg," suggesting that the true extent of the mpox outbreak might be significantly underreported.

The outbreak's severity is underscored by data from the Africa Centres for Disease Control and Prevention (Africa CDC), which declared the mpox outbreak a public health emergency of continental security on Tuesday. This is the first time the agency, established in 2017, has made such a declaration. According to the Africa CDC, more than 17,000 mpox cases and over 500 deaths have been reported across 13 African countries since the start of the year. The DRC has been hit the hardest, accounting for over 14,000 of these cases and 96% of confirmed cases this month alone.

Mpox, formerly known as monkeypox, is a viral disease that can spread easily between humans and from infected animals. The virus is primarily transmitted through close contact, including touching, kissing, or sexual contact, as well as through contaminated materials like bedding, clothing, and needles. Symptoms typically include fever, a painful rash, headaches, muscle and back pain, fatigue, and swollen lymph nodes.

Although mpox has historically been confined to Central and West Africa, the disease began to spread to Europe and North America in 2022. In July of that year, WHO declared the spread of mpox a global health emergency, a status that was maintained until May 2023. The current outbreak, however, is being driven by clade Ib, a more virulent strain than the one responsible for the 2022 spread.

Clades, or genetic groups, of mpox are categorized into two main types: Clade I and Clade II. Clade II was primarily responsible for the 2022 outbreak, but the clade Ib strain now circulating in Africa is known to cause more severe illness. WHO Director-General Ghebreyesus clarified that the world is not facing a single outbreak of one clade but rather multiple outbreaks of different clades, each with varying modes of transmission and levels of risk.

So far, no cases of clade I mpox have been identified in the United States. However, the U.S. Centers for Disease Control and Prevention (CDC) is closely monitoring the situation. The U.S. government has also pledged support to WHO and the DRC in the form of funding, assistance, and vaccines to help combat the spread of the virus in Africa. The CDC recently recommended that individuals in the U.S. who are at high risk of exposure to mpox, or who have been exposed, should consider getting vaccinated.

WHO officials have expressed cautious optimism that the outbreak can be contained, provided that the international community acts swiftly and appropriately. The organization is calling for increased global cooperation in funding and organizing efforts to contain the spread, as well as in supporting research to better understand clade Ib and its transmission dynamics. “It’s clear that a coordinated international response is essential to stop these outbreaks and save lives,” Ghebreyesus emphasized.

To aid in the containment effort, WHO has approved the Emergency Use Listing process for mpox vaccines and has developed a regional response plan that requires $15 million in funding. Of this amount, $1.5 million has already been released from the WHO Contingency Fund for Emergencies. Currently, there are 500,000 doses of the mpox vaccine in stock, with the potential to produce another 2.4 million doses by the end of the year. The DRC and Nigeria are slated to receive the first shipments of these vaccines, according to Dr. Abdou Salam Gueye, WHO's African Regional Emergency Director.

However, WHO officials have stressed that vaccination is only part of the strategy needed to combat the outbreak. Containing the virus will also require enhanced surveillance, improved diagnostics, and further research to fill the gaps in understanding mpox’s spread and impact. “We can stop transmission of mpox with a concerted effort using multiple approaches,” said Dr. Maria Van Kerkhove, director of WHO’s Department of Epidemic and Pandemic Preparedness and Prevention.

“There’s a lot of uncertainty,” Van Kerkhove added. “We have an opportunity right now to really leverage this time and support our member states, to support the research that needs to be done to understand this.”

The ongoing mpox outbreak presents a significant challenge, but WHO officials are confident that with the right measures, the virus can be contained. The declaration of a global health emergency serves as a critical call to action for governments, health agencies, and the international community to work together to halt the spread of the virus and protect vulnerable populations.

In conclusion, the WHO's declaration of the mpox outbreak as a global health emergency underscores the seriousness of the situation in Africa. While the outbreak is currently concentrated in the DRC and surrounding countries, the potential for further spread is a global concern. With coordinated efforts and international support, there is hope that the spread of this deadly strain can be stopped before it escalates further.