Tedros Convenes WHO Emergency Committee to Discuss Monkeypox Outbreak
Monkeypox lesions

Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), has called a meeting of the emergency committee for next Thursday to discuss whether monkeypox should be declared a public health emergency.

This follows the spread of the disease in at least 32 new countries outside of the nine African countries where it is endemic, with 1,600 confirmed cases and a further 1,500 suspected cases reported to the WHO.

“The global outbreak of monkeypox is clearly unusual and concerning. It’s for that reason that I have decided to convene the Emergency Committee under the International Health Regulations next week to assess whether this outbreak represents a public health emergency of international concern,” Tedros told a media briefing on Tuesday.

The WHO has described the identification of over 1,200 confirmed cases of monkeypox in just over three weeks as “an unprecedented event”.

There have been 72 deaths reported this year, all in endemic countries, although the WHO is investigating a possible monkeypox death in Brazil.

“While in the current outbreak most but not all initially reported cases from four WHO regions are among persons who self-identify as men who have sex with men, it is expected that other cases will continue to occur in different population groups,” according to WHO’s vaccine and immunization guidance on monkeypox published on Tuesday.

Renaming monkeypox?

Dr Rosamund Lewis, WHO technical lead on monkeypox

The WHO is also discussing changing the name of monkeypox and its clades, currently known as the Central Africa and West Africa clades.

The WHO is also in discussion with member states about “equitable access” to the smallpox vaccine for monkeypox.

However, WHO monkeypox technical lead Dr Rosamund Lewis warned that while some smallpox vaccines may be protective against monkeypox, a lot of the data is old or relates to animal studies.

“There was not a lot of clinical data and so WHO is calling on countries to work together to collaborate in the use of these vaccines, and to use standard research protocols with standard data collection tools so that we can learn about the effectiveness of vaccines as they are deployed in this situation,” said Lewis.

The WHO does not advocate mass vaccinations but says rather that decisions around immunization with smallpox or monkeypox vaccines should be made on a case-by-case basis through “clinical decision-making, based on a joint assessment of risks and benefits” between a health care provider and a patient.

“Control of monkeypox outbreaks primarily relies on public health measures including surveillance, contact-tracing, isolation and care of patients,” according to the WHO guidelines.

A recent two-day scientific meeting on monkeypox convened by the WHO identified a number of research priorities including whether the disease is spread by people who are asymptomatic and whether those vaccinated against smallpox have lifelong immunity to monkeypox.

Grade three emergency in Horn of Africa

Drought-affected livestock walking to a river in Adadle district in the Somali region of Ethiopia.

The WHO has declared a “grade three emergency” – the highest level possible – in the Horn of Africa, “where the worst drought in 40 years has pushed over 30 million people in eight countries into acute food insecurity,” Tedros said. 

Among the affected countries – Djibouti, Eritrea, Ethiopia, Kenya, Somalia, South Sudan, Sudan and Uganda – an estimated 7.5 million people have left their homes in search of food and water.

‘A grade three emergency means that we are on coordinating the response across all three levels of the organisation: country offices, regional offices and headquarters,” said Tedros. “Our priorities are supporting countries to find outbreaks and to make sure people have access to the essential health services they need.”

Last week, UNICEF reported the 2022 March-May rainy season was “likely to be the driest on record, killing livestock and crops, displacing populations, increasing the risk of disease and malnutrition, and pushing children and families to the brink of death or destitution.”

“Communities are taking extreme measures to survive, with thousands of children and families leaving their homes in pure desperation in search of water, food, and pasture, requiring a collective response by all humanitarian partners,” said UNICEF. “This is a water crisis and more than 8.5 million people, including 4.2 million children, are facing dire water shortages in the region.”

Tedros said there were severe implications for public health.

“Malnourishment can have a lifelong impact on health and makes people increasingly vulnerable to disease,” he said. “Severely malnourished children are nine times more likely to die of this, such as cholera and measles.”

Image Credits: Tessa Davis/Twitter , Michael Tewelde / World Food Program.

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