The World Health Organization (WHO) declared on Wednesday that Mpox will continue to remain a Public Health Emergency of International Concern (PHEIC). The decision to continue with the status quo on Mpox was based on the recommendations made by an Mpox Emergency Committee, whose findings were published on the same day.  

“The emergency committee for the global outbreak of Mpox met to assess whether, in its view, the outbreak remains a public health emergency of international concern. The committee has advised me that, in its view, Mpox remains a global health emergency, and I have accepted that advice,” Dr Tedros Adhanom Ghebreyesus, director-general of the WHO, said at a press briefing on Wednesday.  

In its report, the Mpox committee, which met on 9 February, acknowledged the progress made in reducing the virus transmission and the sharp decline of reported cases. However, it also expressed concerns that “a few countries continued to see a sustained incidence of illness” while in other countries it’s likely that more cases are occuring under the radar.   

“More than 30 countries continue to report cases, and the possible underdetection and under-reporting of confirmed cases in some regions is concerning. Particularly in countries where animal-human transmission of Mpox has been reported before,” Tedros pointed out. 

In its report, the expert committee also expressed concerns about the possible resurgence of cases due to the expected resumption of LGBTQ social events and other mass gathering events; lack of access to vaccines and testing capacities in many lower-income countries; and the recurring zoonotic transmission in Africa.

It added that “not all countries are receiving the support they need or have structures or systems to respond to mpox, including inadequate support for marginalized groups; and general fatigue among supporting agencies.”

Returning from Syrian scenes of devastation

Tedros spoke at the briefing shortly after returning to Geneva from a visit to earthquake affected areas in Syria. The 7.8 magnitude earthquake that hit Syria and Türkiye last week is now estimated to have killed over 41,000 people. 

I've never in my life seen the level of destruction as I did on the road from Aleppo to Damascus. Skeletons of houses. Almost no people in sight. Over a decade of war has taken an unimaginable toll. Syrians need our support now and in years to come to rebuild their lives. pic.twitter.com/Ym2zmDixdw

— Tedros Adhanom Ghebreyesus (@DrTedros) February 14, 2023

Describing the damage caused to Aleppo and Damascus first due to the war, and now by the earthquake, Tedros said “I saw the destruction of entire communities, the unspeakable suffering of people, and the courage and determination of survivors and responders. As we drove from Aleppo to Damascus, I saw the legacy of conflict, with town after town destroyed and abandoned.  Survivors are now facing freezing conditions without adequate shelter, heating, food, clean water, or medical care.”

While two more cross-border points between Türkiye and Syria have been opened, Tedros said he had had asked Syrian president Bashar al-Assad to open still more crossings so that relief could reach people in need more rapidly.  Humanitarian aid groups charge that the Syrian president has “weaponized aid” channeling available supplies to government controlled areas – while most of western Syria where the earthquake hit, is controlled by  Kurdish and other Syrian anti-government militias. 

“WHO remains committed to supporting all people in the Syrian Arab Republic now and in the days, weeks, months, and years ahead,” Tedros added.  

The WHO has launched an appeal for $43 million to support its response in Syria and Türkiye and expects the amount to double by this weekend. Meanwhile, UN Secretary General Antonio Guterres called upon countries to fully fund a $397 million earthquake fund for Syria, in particular, which lacks resources to mount its own response. 

Marburg disease – ramping up diagnostics and clinical trial possibilities

Touching back on the Marburg Virus Disease (MVD) outbreak in Equatorial Guinea, which has claimed nine lives, Tedros said that the WHO is working with the country’s health authorities to ramp up their diagnostic capacity. 

“So far, no confirmed cases have been reported in Cameroon and or Gabon,” he added, referring to the two countries that, along with Liberia, border Equatorial Guinea. “We’re also supporting the governments of Cameroon and Gabon to prepare to rapidly detect, isolate, and provide care for any suspected cases.” 

Following up on the Marburg Virus Vaccine Consortium (MARVAC)’s meeting on Tuesday, Tedros said that WHO is trying to accelerate talks on possibile clinical trials for Marburg virus diseaes vaccine candidates. But he reiterated that any decision on the trials of vaccines and therapeutics for Marburg needs to be taken by researchers and the national authorities of Equatorial Guinea. 

“In the meantime, WHO is convening the vaccine prioritization committee to identify which vaccine candidates should be evaluated first and prepare for potential trials. WHO is also discussing with the ministry of health, the possibility of providing access to experimental therapeutics as part of a clinical trial,” he said.