WHO declares monkeypox outbreak as public health emergency of international concern

For the moment this is an outbreak that is concentrated among men who have sex with men

Geneva: The World Health Organization today declared the monkeypox outbreak as a public health emergency of international concern. Making the declaration, WHO Director-General Dr Tedros Adhanom Ghebreyesus said that the outbreak spread around the world rapidly, through new modes of transmission, “about which we understand too little, and which meets the criteria in the International Health Regulations”. According to him, there was a clear risk of further international spread of monkeypox, “although the risk of interference with international traffic remains low for the moment”.

Dr Ghebreyesus made the declaration after the second meeting of the Emergency Committee under the International Health Regulations to assess whether the multi-country monkeypox outbreak represented a public health emergency of international concern. In light of the evolving outbreak, the WHO D-G reconvened the committee on July 21, 2022, to review the latest data and advise him accordingly.

He made the declaration as the outbreak has continued to grow, and there are now more than 16 thousand reported cases from 75 countries and territories and five deaths. Significantly, the Emergency Committee was unable to reach a consensus on whether the outbreak represented a public health emergency of international concern.

“I know this has not been an easy or straightforward process, and that there are divergent views among the members. The International Health Regulations remain a vital tool for responding to the international spread of disease.  But this process demonstrates once again that this vital tool needs to be sharpened to make it more effective,” he said and disclosed that alongside the process of negotiating a new international accord on pandemic preparedness and response, WHO’s Member States are also considering targeted amendments to the International Health Regulations, including ways to improve the process for declaring a public health emergency of international concern.

“Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners. That means that this is an outbreak that can be stopped with the right strategies in the right groups,’ he clarified.

The WHO D-G said it was essential that all countries work closely with communities of men who have sex with men, to design and deliver effective information and services, and to adopt measures that protect the health, human rights and dignity of affected communities. 

“Stigma and discrimination can be as dangerous as any virus. In addition to our recommendations to countries, I am also calling on civil society organizations, including those with experience in working with people living with HIV, to work with us on fighting stigma and discrimination,” he said.

It may be mentioned that a month ago too, the D-G had convened the Emergency Committee under the International Health Regulations to assess whether the multi-country monkeypox outbreak represented a public health emergency of international concern. At the time, 3040 cases of monkeypox had been reported to WHO, from 47 countries.  At that meeting, while differing views were expressed, the committee resolved by a consensus that the outbreak did not represent a public health emergency of international concern. 

However, since then, the outbreak has continued to grow. Dr Gebreyesus explained that under the International Health Regulations, he was required to consider five elements in deciding whether an outbreak constitutes a public health emergency of international concern:

1. The information provided by countries – which in this case shows that this virus has spread rapidly to many countries that have not seen it before;
2. The three criteria for declaring a public health emergency of international concern under the International Health Regulations, have been met; 
3. The advice of the Emergency Committee, which has not reached a consensus;
4. Scientific principles, evidence and other relevant information are currently insufficient and leave WHO with many unknowns; 
5. The risk to human health, international spread, and the potential for interference with international traffic. 

WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where it assessed the risk as high. Accordingly, the D-G said, he has made a set of recommendations for four groups of countries:

1. Those that have not yet reported a case of monkeypox, or have not reported a case for more than 21 days; 
2. Those with recently imported cases of monkeypox and that are experiencing human-to-human transmission. This includes recommendations to implement a coordinated response to stop transmission and protect vulnerable groups; to engage and protect affected communities; to intensify surveillance and public health measures; to strengthen clinical management and infection prevention and control in hospitals and clinics; to accelerate research into the use of vaccines, therapeutics and other tools; and recommendations on international travel.
3. Those with the transmission of monkeypox between animals and humans;
4. Those with manufacturing capacity for diagnostics, vaccines and therapeutics.

“With the tools we have right now, we can stop transmission and bring this outbreak under control,” the D-G said.

– global bihari bureau