The World Health Organization (WHO) has declared an international public health emergency for mpox virus, its highest level of alarm, as the virus experiences a resurgence across Africa less than two years after ending the previous emergency.
The declaration comes as the case total in Africa this year has already surpassed the total from 2023. Over 2,500 cases and 56 deaths were reported across the African Union last week alone. Since January, 17,541 mpox cases have been reported across 13 AU states, according to the latest Africa CDC epidemic intelligence report published August 9.
“Today, the Emergency Committee met and advised me that, in its view, the situation constitutes a public health emergency of international concern,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said at a briefing on Wednesday. “I have accepted that advice.”
The Democratic Republic of Congo (DRC) is at the heart of the outbreak, accounting for more than 96% of both cases and deaths. A new variant of the virus, Clade 1b, has spread from the DRC to countries that have never reported mpox cases before, including Burundi, Kenya, Rwanda, and Uganda.
In the DRC, where mpox was first detected in 1970 and remains endemic, 60% of cases involve children under 15 years old, Africa CDC reports.
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The WHO announcement follows a similar declaration by Africa CDC on Tuesday, when it declared its first-ever continental emergency of international concern since the agency’s founding in 2016.
“We declare today this public health emergency of continental security to mobilize our institutions, our collective will, and our resources to act swiftly and decisively,” said Africa CDC Director-General John Kaseya.
Both emergency declarations were based largely on evidence that the primary mode of circulation for the current mpox outbreak is person-to-person transmission, primarily through sexual networks. This differs from the historical pattern of zoonotic transmission from animals to humans.
“The potential for further spread within Africa and beyond is very worrying,” Tedros said. “It’s clear that a coordinated international response is essential to stop these outbreaks and save lives.”
The African Union has approved $10.4 million to support Africa CDC’s crisis response efforts. The funding will target securing vaccines, improving epidemic surveillance, and assisting in overall preparedness and response efforts. The WHO has also released an additional $1.45 million from its emergency fund to support the African response.
Despite these actions, continental response systems remain underprepared and under-resourced. Africa needs an estimated 10 million vaccine doses but currently has only 200,000 available. Deployment of these vaccines has also been problematic. While the DRC received 50,000 doses donated by the United States, they have yet to be put to use. Meanwhile, doctors on the frontlines of the outbreak report that no vaccines are available at all.
“We have to be very strategic in who we use the limited number of vaccines,” said Professor Salim Abdool Karim, head of the Africa CDC Emergency Consultative Group convened to assess the need for an emergency declaration. “Healthcare workers have been one of the groups that have to be addressed.”
Vaccine stockpiles exist in several countries outside Africa. The United States purchased 500,000 doses last year, and an undisclosed European country also made several orders. Other countries such as Japan and Canada also have stockpiles of the vaccine.
The WHO is working with international partners to coordinate what it calls “vaccine donations.” However, the willingness of countries to share their stockpiles remains unclear. The Globe and Mail reported this week that officials from Canada’s Ministry of Health said they have no plans to share their national stockpile with the frontline countries in the African outbreak.
Africa CDC said in Tuesday’s press briefing that a plan to secure the necessary doses is in place. “We have a clear plan to secure more than 10 million doses in Africa, starting with 3 million doses in 2024,” Kaseya added, without specifying the source or timeline for these vaccines.
This potential declaration comes just over a year after WHO ended the previous global health emergency for mpox in May 2023. The earlier crisis, declared in July 2022, stemmed from a worldwide outbreak mainly affecting men who have sex with men. About 90,000 cases and 140 deaths were reported across 111 countries during that emergency.
Mpox has been endemic in parts of Africa for decades, with the first human case detected in the DRC in 1970. The current outbreak underscores the ongoing challenges in controlling the virus in its endemic regions and the need for a coordinated global response to prevent its spread.
The World Health Organization has convened 10 International Health Regulations Emergency Committees to date, addressing global health concerns such as COVID-19, Ebola, H1N1, MERS-CoV, and Zika virus.
This is a developing story.
