WHO weighs international emergency status for mpox surge in Africa

The World Health Organization’s (WHO) chief said he was considering convening an expert committee to advise on whether the growing mpox outbreak in Africa should be declared an international emergency.

Since last September, cases have surged in the Democratic Republic of Congo due to a strain of the virus, which has recently been detected in nearby African countries.

WHO director-general Tedros Adhanom Ghebreyesus said the U.N. health agency, the Africa Centres for Disease Control and Prevention (CDC), local governments and partners were increasing their response to the outbreak.

“But more funding and support for a comprehensive response are needed,” Tedros said on the social media platform X.

“I am considering convening an International Health Regulations emergency committee to advise me on whether the outbreak of mpox should be declared a public health emergency of international concern.”

A PHEIC is the highest alarm the WHO can sound. Tedros, as WHO director-general, can declare such an emergency on the advice of a committee of experts in the field.

In a statement to the journal Science, Tedros added: “This virus can and must be contained with intensified public health measures including surveillance, community engagement, treatment and targeted deployment of vaccines for those at higher risk of infection.”

Different strain

Formerly known as monkeypox, mpox is an infectious disease caused by a virus transmitted to humans by infected animals that can also be passed from human to human through close physical contact.

It was first discovered in humans in 1970 in the Democratic Republic of Congo.

The disease causes fever, muscular aches and large boil-like skin lesions.

There are two subtypes of the virus: The more virulent and deadlier Clade I, endemic in the Congo Basin in central Africa; and Clade II, endemic in West Africa.

In May 2022, mpox infections surged worldwide due to the Clade IIb subclade.

The outbreak led the WHO to declare a PHEIC, which lasted from July 2022 to May 2023. That outbreak has now largely subsided.

Since September 2023, a different strain of mpox, the Clade Ib subclade, has been surging in the DR Congo.

On July 11, Tedros said more than 11,000 cases and 445 deaths had been reported in the DRC this year, with children the most affected.

The African Union (AU) said Friday it had ‘urgently approved $10.4 million from COVID-19 funds to support the CDC in continuing efforts to combat the mpox outbreak across the continent.

The AU added that it will help increase monitoring, laboratory testing, regional and national data collection, case and infection management, and access to vaccines.

In late July, Burundi reported three cases and Kenya registered a single case.

Then, on Saturday, Uganda announced that its first two cases had been detected, with indications that the infections took place in the neighboring DRC.

The International Health Regulations are the framework defining countries’ rights and obligations in handling public health events that could cross borders. The IHR is legally binding on 196 countries.

Under the IHR, the WHO chief can declare a PHEIC, triggering emergency responses under the regulations.

A PHEIC has only been declared seven times from 2009 onwards: over H1N1 swine flu, poliovirus, Ebola, Zika virus, Ebola again, COVID-19 and mpox.