Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization (WHO), has declared monkeypox a Public Health Emergency of International Concern (PHEIC). This decision comes in response to the sudden rise in monkeypox cases in the Democratic Republic of the Congo (DRC) and an increasing number of cases in several African countries. The declaration was made under the International Health Regulations (2005) (IHR).
Dr. Tedros made this announcement following the advice of the IHR Emergency Committee, composed of independent experts. The committee met earlier to review data presented by WHO experts and the affected countries.
The committee informed the Director-General that they consider the surge in monkeypox cases a public health emergency with the potential for wider spread across African countries and possibly beyond the continent.
In his announcement, Dr. Tedros stated, “The emergence of a new strain of monkeypox, its rapid spread in eastern DRC, and reports of cases in neighboring countries are highly concerning. Coupled with the outbreak of other monkeypox strains in the DRC and other African nations, it is clear that a coordinated international response is needed to halt these epidemics and save lives.”
Dr. Matshidiso Moeti, WHO Regional Director for Africa, added, “Significant efforts are already underway in close collaboration with communities and governments. Our teams are on the front lines in the affected countries, working to strengthen measures to limit the spread of monkeypox. With the virus’s increasing spread, we are expanding coordinated international efforts to support countries in ending the outbreak.”
Professor Dimi Ogoina, Chair of the Emergency Committee, emphasized, “The current rise in monkeypox cases in parts of Africa, along with the spread of a new strain transmitted through sexual contact, constitutes an emergency not just for Africa but for the entire world. Monkeypox, which originated in Africa, has been neglected, leading to a global outbreak in 2022. It is time to take decisive action to prevent history from repeating itself.”
This WHO declaration marks the second PHEIC related to monkeypox in two years. The disease was first identified in humans in 1970 in the DRC and is endemic in Central and West African countries. In July 2022, the global monkeypox outbreak was declared a PHEIC after the virus spread rapidly through sexual contact across several countries where it had not been previously observed. The international emergency was lifted in May 2023 following a sustained decrease in global cases.
Monkeypox has been reported in the DRC for over a decade, with cases steadily increasing each year. Last year, the number of reported cases surged significantly, surpassing the total from the previous year with over 15,600 cases and 537 deaths reported so far this year.
The emergence of a new viral strain last year, its rapid spread in the DRC—specifically strain 1b, which appears to spread primarily through sexual networks—and its detection in neighboring countries is particularly alarming and one of the main reasons for declaring a PHEIC.
Last month, over 100 laboratory-confirmed cases of strain 1b were reported in four neighboring countries that had not previously reported monkeypox cases: Burundi, Kenya, Rwanda, and Uganda. Experts believe the true number of cases is higher, as a significant portion of clinically compatible cases have not been tested.
Several outbreaks of different monkeypox strains have occurred in various countries, with different modes of transmission and varying levels of risk.
The WHO Strategic Advisory Group of Experts on Immunization (SAGE) has recommended the two currently used vaccines against monkeypox, which have also been approved by national regulatory authorities listed with WHO, as well as by individual countries including Nigeria and the DRC.
Last week, the Director-General initiated the process to include monkeypox vaccines in the WHO Emergency Use Listing, which would expedite vaccine access to low-income countries that have not yet issued their own regulatory approval. The Emergency Use Listing also allows partners, including Gavi and UNICEF, to purchase vaccines for distribution.
WHO is working with countries and vaccine manufacturers on potential vaccine donations and coordinating with partners through the Access to COVID-19 Tools (ACT) Accelerator to facilitate equitable access to vaccines, treatments, diagnostics, and other tools.
WHO expects to need an initial $15 million USD in immediate funding to support surveillance, preparedness, and response activities, with needs currently being assessed at all three levels of the organization.
To enable an immediate scale-up of the response, WHO has allocated $1.45 million USD from its Contingency Fund for Emergencies, with the possibility of allocating more funds in the coming days. WHO is also calling on donors to fully fund the monkeypox response.
