WHO Director-General declares mpox outbreak a public health emergency of international concern – PAHO/WHO

Geneva, August 14, 2024 (PAHO).- WHO Director-General Dr. Tedros Adhanom Ghebreyesus has determined that the increase in mpox cases in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR).

Dr Tedros’ statement came on the recommendation of an IHR Emergency Committee of independent experts that met earlier in the day to review data submitted by WHO and affected country experts. The Committee informed the Director-General that it considers the resurgence of coronavirus pneumonia to constitute a public health emergency of international concern (PHEIC), with the potential to spread to other countries in Africa and possibly beyond the continent.

The Director-General will share the report of the Committee meeting and, based on the Committee’s advice, issue temporary recommendations to countries.

Declaring the PHEIC, Dr Tedros said: «The emergence of a new mpox clade, its rapid spread in eastern DRC and the reporting of cases in several neighbouring countries are of great concern. Coupled with outbreaks of other mpox clades in DRC and other countries in Africa, it is clear that a coordinated international response is needed to stop these outbreaks and save lives.»

WHO Regional Director for Africa Dr Matshidiso Moeti said: “Important efforts are already underway in close collaboration with communities and governments, and our country teams are working on the front line to help strengthen measures to curb mpox. As the virus continues to spread, we are further scaling up coordinated international action to help countries end outbreaks.”

Committee Chair Professor Dimie Ogoina said: “The current surge of monkeypox virus in parts of Africa, coupled with the spread of a new sexually transmitted strain of monkeypox virus, is an emergency, not just for Africa, but for the entire world. Monkeypox virus, which originated in Africa, was neglected there and then caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself.”

This is the second mpox-related ESPII determination in two years. Caused by an orthopoxvirus, mpox was first detected in humans in 1970 in the Democratic Republic of the Congo. The disease is considered endemic in countries in central and western Africa.

In July 2022, the multi-country outbreak of mpox was declared a PHEIC, as it spread rapidly through sexual contact in a number of countries where the virus had not been detected before. That PHEIC was declared over in May 2023, after a sustained decline in cases had occurred globally.

Mpox disease has been detected in the Democratic Republic of the Congo for more than a decade and the number of reported cases each year has increased steadily over that period. Last year, reported cases increased significantly and so far, the number of reported cases this year has already surpassed last year’s total, with more than 15,600 cases and 537 deaths.

The emergence last year and rapid spread of a new strain of the virus in the Democratic Republic of the Congo, clade 1b, which appears to spread mainly through sexual networks, and its detection in countries neighbouring the Democratic Republic of the Congo are of particular concern and one of the main reasons for the declaration of the PHEIC.

In the past month, more than 100 laboratory-confirmed cases of clade 1b have been reported in four countries neighbouring the Democratic Republic of the Congo that had not previously reported mpox cases: Burundi, Kenya, Rwanda and Uganda. Experts believe that the actual number of cases is higher, as a large proportion of clinically compatible cases have not been tested.

Several outbreaks of different mpox clades have occurred in different countries, with different modes of transmission and different levels of risk.

The two vaccines currently used for mpox are recommended by the WHO Strategic Advisory Group of Experts on Immunization and are also approved by national regulatory authorities listed by WHO, as well as by individual countries, including Nigeria and the Democratic Republic of the Congo.

Last week, the Director-General launched the process for Emergency Use Listing of mpox vaccines, which will accelerate access to vaccines for low-income countries that have not yet issued their own national regulatory approval. Emergency Use Listing also enables partners, such as Gavi and UNICEF, to procure vaccines for distribution.

WHO is working with countries and vaccine manufacturers on potential vaccine donations and coordinating with partners through the Interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics and other tools.

WHO anticipates an immediate funding need of US$15 million to support surveillance, preparedness and response activities. A needs assessment is underway at all three levels of the Organization.

To enable an immediate scale-up of assistance, WHO has released $1.45 million from the WHO Contingency Emergency Fund and may need to release more in the coming days. The Organization is appealing to donors to fully fund the emergency response needs.