WHO Considers if Monkeypox Constitutes a Global Health Emergency 
Monkeypox rash.

A World Health Organization emergency committee met Thursday to determine if the monkeypox outbreak spreading in non-endemic countries constitutes a Public Health Emergency of International Concern (PHEIC).

The closed door meeting, including 16 committee members and eight advisors, will make a recommendation to WHO Director-General Dr Tedros Adhanom Ghebreyesus, who will decide whether to designate it a public health emergency.

Tedros told a WHO media briefing last week the global outbreak of monkeypox “is clearly unusual and concerning.” His decision is not expected before Friday, according to a WHO media advisory.

Ibrahima Socé Fall, WHO’s deputy director for emergency response, said it is important to take preventive action now because the risk of spread in Europe is “high” and in other parts of the world it is “moderate,” though much is still unknown about how the virus is being transmitted.

“We don’t want to wait until the situation is out of control,” he said.

More than 3000 monkeypox cases globally, experts urge WHO to take action 

With 3,543 confirmed and suspected cases across 59 countries outside of central and western Africa as of Thursday, other global health organizations have already begun to declare monkeypox a public health emergency, with experts urging WHO to take immediate action to combat what some of them consider to be another pandemic.

Public health research coalition World Health Network declared monkeypox a pandemic on Thursday. 

“There is no justification to wait for the monkeypox pandemic to grow further. The best time to act is now. By taking immediate action, we can control the outbreak with the least effort, and prevent consequences from becoming worse,” said Yaneer Bar-Yam, WHN’s founder and president of New England Complex System Institute.

In places like New York City, public health clinics are offering vaccinations against the disease. 

Monkeypox has plagued Africa for years 

Cases of monkeypox in endemic countries between 15 December 2021 to 1 May 2022

Some experts in Africa have said the WHO consultation is long overdue, but for different reasons. Global concern has only arisen recently, despite the fact that monkeypox has plagued Africa for years.

In 2022 some 1536 suspected cases and 72 deaths have been reported by WHO in the eight countries where the disease is endemic in 2022.

In the case of the more lethal West African clade, the disease can have a fatality rate of up to 10%. 

The different responses to the disease in Africa and Europe have drawn growing attention. “When a disease affects developing countries, it is (apparently) not an emergency. It only becomes an emergency when developed countries are affected,” Emmanuel Nakoune, acting director of Institut Pasteur in Bangui, Central African Republic, told Reuters.

Nakoune, who is running a clinical trial for a monkeypox treatment, said that if WHO declares monkeypox a public health emergency, that would at least be an important step in the right direction. And each will be able to benefit, he said, “if there is the political will to share equitably the means of response between developed and developing countries.”

More intensive person-to-person transmission seen in Europe 

The clade of the virus spreading in Europe was previously seen largely in West African countries, with the exception of isolated cases carried abroad by travelers. But person to person transmission of the virus in African settings was typically limited, with outbreaks occurring largely as a result of contact with wild animal populations, including infected rodents and squirrels

In Europe, in contrast, the virus is spreading exclusively through person-to-person transmission, including as a result of men having sex with men or other forms of skin-to skin contact.

Meanwhile, a team of African researchers, including the acting director of the Africa Centers for Disease Control, proposed a new nomenclature for the virus out of concern that the current terms are racist and stigmatizating.  

The proposal calls for the virus to be named in terms of its variants, such as MPXV Clades 1, 2, and 3, in order of discovery.  Newer variants are more likely to be the ones carrying the disease abroad. 

If monkeypox is designated as a public health emergency, or PHEIC, under WHO’s International Health Regulations, it could help unlock more funding from WHO and governments that would help to get transmission under control.  Countries would have a legal obligation to implement their own public health measures.  

Such an emergency declaration also could underpin WHO plans to ensure an equitable distribution of available smallpox and monkeypox vaccines that are effective against the virus. Such vaccines are available now only in wealthy countries.

Only six disease outbreaks have been declared a PHEIC since 2007: swine flu, polio, Ebola, Zika, Kivu Ebola and COVID-19.  [See the WHO explainer about Monkeypox symptoms and treatment below.]


Image Credits: Diverse Stock Photos , WHO, Disease Outbreak News, 21 May 2022 .

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