WHO Will Reconsider Declaring Monkeypox a Health Emergency in 21 Days – If Certain Criteria Are Met
Monkeypox rash

Although the World Health Organization (WHO) has decided not to declare monkeypox a public health emergency of international concern (PHEIC), it could change its mind if there is evidence of “significant spread” in the next 21 days.   

This was announced over the weekend following the meeting of the WHO’s International Health Regulations (IHR) Emergency Committee. The Committee also recommended more aid to the 9-12 central and west African countries where the disease has long circulated, often as a result of contact with infected rodents, squirrels and other wild animals.  

According to the IHR, a public health emergency is “an extraordinary event, which constitutes a public health risk to other States through international transmission, and which potentially requires a coordinated international response”.

While the WHO conceded in its official statement that the outbreak was “unusual” in many aspects and that “a few” committee members felt it should be declared a PHEIC, it listed a number of requirements that might lead to a change in position in three weeks time. 

These would include: more cases both among and beyond the population groups currently affected; cases among sex workers; evidence of significant spread to and within additional countries; and an increase of cases in vulnerable groups, such people with poorly controlled HIV, pregnant women, and children.

Between 1 January and 22 June 2022, some 3413 laboratory confirmed cases and one death have been reported to WHO from 50 countries/territories in five WHO Regions, WHO reported on Monday, 27 June.     

‘Equitable access to lifesaving tools’

Reacting to the WHO announcement, Wellcome Trust’s Director of Infectious Diseases, Professor Gordon Dougan, urged all affected countries to “integrate their preparations and help those with limited capability”. 

“Governments do not need to wait for an official declaration to begin acting in a coordinated and measured way. Where cases have been identified, rapid public health responses such as enhanced disease surveillance, contact tracing and self-isolation will be crucial,” said Dougan.

However, he also called out the rush by some countries to acquire scarce vaccines despite mass vaccination not being recommended, urging the global community not to repeat mistakes made during the COVID-19 response.

“But while high-income countries are now paying attention to this virus, monkeypox has been affecting people in West and Central Africa for decades. And with new cases now being reported in other low- and middle-income countries, we must ensure that these lifesaving tools are equitably distributed to where they are needed most,” Dougan urged.

The response also required “establishing clinical trials of the required scale and design” to ensure improved  monkeypox vaccines and treatments, he added.

The WHO emergency committee also noted that monkeypox has been endemic in parts of Africa “for decades”, and that responding to the current outbreak should “serve as a catalyst to increase efforts to address monkeypox in the longer term and access to essential supplies worldwide”.

Cases plateauing?

Some of the issues influencing the WHO’s decision included “current observations of plateauing or potential downward trends in case numbers in some of the countries experiencing outbreak early on” as well as “the need for further understanding of transmission dynamics”.

“However, the committee unanimously acknowledged the emergency nature of the event and that controlling the further spread of outbreak requires intense response efforts,” added the WHO.

“The committee advised that the event should be closely monitored and reviewed after a few weeks, once more information about the current unknowns becomes available, to determine if significant changes have occurred that may warrant a reconsideration of their advice.”

Image Credits: US Centers for Disease Control.

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