WHO Director-General Dr Tedros Adhanom Ghebreyesus has determined that the sudden increase in MPOX in the Democratic Republic of the Congo (DRC) and a growing number of African countries constitutes a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005) (IHR).
Dr Tedros' declaration was made on the advice of the IHR Emergency Committee of Independent Experts, which met earlier in the day to consider data submitted by WHO and experts from affected countries. The Committee informed the Director-General that the MPOX surge is a PHEIC, with the potential to spread further into African countries and possibly beyond the continent.
The Secretary-General will share the reports of the Committee's meetings and issue interim recommendations to countries based on the Committee's advice.
In declaring a PHEIC, Dr Tedros said, “The emergence of a new MPOX lineage, its rapid spread in eastern DRC, and reported cases in several neighbouring countries are extremely worrying. This, along with other MPOX lineage outbreaks in the DRC and other African countries, clearly requires a coordinated international response to stop these outbreaks and save lives.”
“In close collaboration with communities and governments, important efforts are already underway, with country teams on the frontline working to strengthen MPOX prevention measures. As the virus spreads, we are further scaling up through coordinated international action to help countries end the outbreak,” said Dr Matshidiso Moeti, WHO Regional Director for Africa.
“The current surge in monkeypox in parts of Africa, and the spread of a new sexually transmitted strain of monkeypox virus, is an emergency not only for Africa but for the entire planet. Monkeypox originated in Africa, was ignored there and then led to a global pandemic in 2022. It is time to take decisive action to prevent history from repeating itself,” said Professor Dimier Ogoyena, chair of the committee.
This PHEIC determination is the second in two years related to MPOX. Caused by an orthopoxvirus, MPOX was first detected in humans in the Democratic Republic of Congo in 1970. The disease is considered endemic to countries in Central and West Africa.
In July 2022, a multi-country outbreak of MPOX was declared a PHEIC due to rapid spread via sexual contact in various countries where the virus had not previously been identified. This PHEIC was declared over in May 2023 following a sustained decline in the number of global cases.
Mpox has been reported in the Democratic Republic of Congo for over a decade and the number of cases reported each year has steadily increased over that time. Last year saw a significant increase in reported cases, with the number of reported cases so far this year already exceeding last year's total, with over 15,600 cases and 537 deaths.
Last year, a new virus strain (lineage 1b) emerged in the Democratic Republic of the Congo and has spread rapidly. This virus strain is thought to be spread mainly through sexual networks and its detection in neighbouring countries of the Democratic Republic of the Congo is of particular concern and is one of the main reasons for the declaration of a PHEIC.
Over the past month, four countries bordering the Democratic Republic of Congo – Burundi, Kenya, Rwanda and Uganda – have reported over 100 laboratory-confirmed cases of the previously unreported MPOX 1b lineage. Experts believe the true number of cases is higher as a large proportion of clinically compatible cases have not been tested.
There are multiple outbreaks caused by different strains of MPOX in different countries, with different routes of transmission and different levels of risk.
The two vaccines currently used for mpox have been recommended by the WHO Strategic Advisory Group of Experts on Immunization and have also been approved by regulatory authorities in WHO-listed countries, as well as by individual countries, including Nigeria and the Democratic Republic of the Congo.
Last week, the Executive Director launched the process for emergency use listing of the mpox vaccine, which will accelerate access to the vaccine in low-income countries that have not yet issued their own regulatory approval. The emergency use listing also allows partners such as Gavi and UNICEF to procure the vaccine for distribution.
WHO is working with countries and vaccine manufacturers on possible vaccine donations, and with partners through the Interim Health Response Network to facilitate equitable access to vaccines, therapeutics, diagnostics and other tools.
WHO estimates an initial immediate funding requirement of $15 million to support surveillance, preparedness and response activities. A needs assessment is being conducted across three levels of the organization.
WHO has released $1.45 million from the WHO Emergency Response Fund to enable the emergency response, and further contributions may be needed in the coming days. WHO is calling on donors to fully fund the MPOX response.
