The World Health Organization (WHO) declared mpox a global public health emergency for the second time in two years, following a surge in cases in DR Congo and neighboring countries. This announcement was made on Wednesday, August 14, after an emergency committee of independent experts reviewed data on the outbreak.
WHO Director-General Dr Tedros Adhanom Ghebreyesus stated that the emergence of a new strain of the virus and its rapid spread in eastern DR Congo, as well as in several neighbouring countries is a serious concern requiring coordinated international action to curb the virus and prevent further loss of life.
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The emergency committee’s advice was essential in making the Public Health Emergency of International Concern (PHEIC) declaration, stressing the potential for the virus to spread beyond Africa.
WHO Regional Director for Africa Dr Matshidiso Moeti said, "Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to help reinforce measures to curb mpox. With the growing spread of the virus, we’re scaling up further through coordinated international action to support countries bring the outbreaks to an end.”
Committee Chair Professor Dimie Ogoina said, "The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."
The declaration of this emergency follows the Africa Centres for Disease Control and Prevention’s (Africa CDC) own declaration of a Public Health Emergency of Continental Security (PHECS) on Tuesday, August 13.
This was the first PHECS since the Africa CDC was established in 2017.
Dr. Jean Kaseya, the Africa CDC Director General, highlighted the necessity of immediate and decisive action to mobilise resources, strengthen health systems, and educate communities. He said that there is no need for travel restrictions at this time.
At least 13 African countries, including previously unaffected nations like Burundi, Kenya, Rwanda, and Uganda, reported mpox outbreaks. As of mid-August, there have been 2,863 confirmed cases and 517 deaths, primarily in DR Congo.
The number of suspected cases across the continent has surged past 17,000, a sharp increase from previous years. This spike is due to gaps in surveillance, laboratory testing, and contact tracing.
Dr. Kaseya stressed the severity of the situation, calling for international partners to act swiftly and work closely with the Africa CDC to provide necessary support.
The WHO reports that the number of new cases reported globally in June was substantial, with Africa accounting for 61% of these new cases. This ongoing transmission emphasises the need for enhanced global cooperation.
The outbreak, which initially gained attention in 2022, was declared a PHEIC in July 2022 due to its rapid spread across countries where mpox was previously unknown.
Though the emergency status was lifted in May 2023 as global cases declined, Africa’s situation has worsened, with a 160% increase in reported cases from January to July 2024 compared to the same period in 2023.
The emergence last year and rapid spread of a new mpox strain in DR Congo, clade 1b, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring DR Congo is especially concerning, and one of the main reasons for the declaration of the PHEIC. In the past month, over 100 laboratory-confirmed cases of clade 1b have been reported in four countries neighbouring DR Congo that have not reported mpox before: Burundi, Kenya, Rwanda and Uganda.
Experts believe the true number of cases to be higher as a large proportion of clinically compatible cases have not been tested.
Currently, two vaccines for mpox have been recommended by WHO’s Strategic Advisory Group of Experts on Immunization and approved by national regulatory authorities.
WHO is working to expedite vaccine access for lower-income countries through Emergency Use Listing and coordinating with partners for vaccine donations. An initial funding requirement of $15 million has been projected to support surveillance, preparedness, and response efforts.
WHO has already released $1.45 million from its Contingency Fund and is appealing for further donations to meet the full needs of the response.
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Mpox spreads through contact with bodily fluids, skin lesions, respiratory droplets, and contaminated objects. Symptoms include fever, rash, and swollen lymph nodes, with severe illness potentially lasting up to three days. The mortality rate varies but can be as high as 11%, particularly among young children.
Considering the escalating situation, WHO stresses the importance of raising community awareness and educating health workers to prevent further transmission. The ongoing global response aims to manage and mitigate the outbreak effectively while addressing the needs of the most affected regions.