On Wednesday, the World Health Organization (WHO) declared the ongoing mpox outbreak in Africa a global health emergency.
The WHO convened its emergency committee to address concerns about a more dangerous strain of the virus, known as clade Ib, which had spread to four countries in Africa previously unaffected by the outbreak. This strain had previously been limited to the Democratic Republic of Congo (DRC).
The committee met virtually to advise WHO Director-General Tedros Adhanom Ghebreyesus on the outbreak’s severity. Following this consultation, Tedros announced the declaration of a public health emergency of international concern (PHEIC), the highest level of alarm under international health law.
“The detection and rapid spread of a new clade of mpox in eastern DRC, its appearance in neighboring countries previously unaffected, and the potential for further spread within Africa and beyond is very concerning,” Tedros stated.
The PHEIC status is assigned to “extraordinary events” that pose a public health risk across borders and may require a coordinated international response, according to the WHO.
Dimie Ogoina, chair of the emergency committee, remarked, “It was unanimous that the current outbreak of mpox is an extraordinary event. What we are seeing in Africa is just the tip of the iceberg… We do not yet fully grasp the extent of the mpox burden.”
On Tuesday, the Africa Centres for Disease Control and Prevention (Africa CDC) also declared the outbreak a public health emergency of continental security. This was the first such declaration by the agency since its establishment in 2017.
Since the beginning of the year, Africa has reported over 17,000 mpox cases and more than 500 deaths across 13 countries. The DRC, which accounts for over 96% of confirmed cases this month, has been the hardest hit, with more than 14,000 cases reported.
Mpox, previously known as monkeypox, is a viral disease that can spread through close contact, including touching, kissing, sex, and contaminated materials such as bedding and clothing. Symptoms include fever, a painful rash, headache, muscle and back pain, low energy, and swollen lymph nodes. Historically confined to Central and West Africa, mpox began spreading to Europe and North America in 2022. The WHO declared the spread of mpox a global health emergency in July 2022 and lifted the declaration in May 2023.
Mpox is categorized into two genetic clades, I and II. Clade II was responsible for the 2022 outbreak, while clade Ib, which causes more severe illness, is currently spreading.
“We are not dealing with a single outbreak or clade but multiple outbreaks involving different clades in various countries with varying modes of transmission and risk levels,” Tedros explained.
Although no cases of clade I mpox have been reported in the United States, the CDC is monitoring the situation and has offered support, including funding, assistance, and vaccines to the WHO and the DRC.
The CDC recently recommended vaccination for individuals in the U.S. who are exposed to or at high risk of mpox.
WHO officials have indicated that the virus could be contained with the right measures. They are calling for increased international cooperation for financing, organizing efforts, and research to understand clade Ib better.
“A coordinated international response is crucial to halt these outbreaks and save lives,” Tedros emphasized.
The WHO has endorsed the Emergency Use Listing process for mpox vaccines and developed a regional response plan requiring $15 million, with $1.5 million already allocated from the WHO Contingency Fund for Emergencies. Currently, half a million vaccine doses are available, with the potential to produce an additional 2.4 million by the end of the year. The DRC and Nigeria are prioritized for vaccine distribution.
While vaccines are a critical part of the response, the WHO stresses the need for enhanced surveillance, diagnostics, and research to address gaps in understanding.
“We can stop the transmission of mpox with a concerted effort using multiple approaches,” said Dr. Maria Van Kerkhove of WHO’s Department of Epidemic and Pandemic Preparedness and Prevention. “There’s a lot of uncertainty, but we have a chance to leverage this moment to support research and understanding.”