WHO declares mpox surge in Africa a global health emergency

The World Health Organization has declared mpox a global public health emergency after a surge of cases in west Africa.

Scientists are worried about the rising number of cases in the Democratic Republic of Congo and the disease’s spread to nearby countries. The new clade of mpox, known as clade 1b, is more severe.

The DRC has reported more than 14,000 cases and 524 deaths so far this year, which have exceeded last year’s total. The virus has also been detected in Burundi, Kenya, Rwanda and Uganda, countries which had not previously reported mpox.

A global public health emergency is the highest level of alarm under International Health Regulations, which are legally binding on 196 countries.

The WHO decision taken on Wednesday means a global response is necessary to contain the outbreak.

“Today, the emergency committee met and advised me that in its view, the situation constitutes a public health emergency of international concern. I have accepted that advice,” WHO chief Tedros Adhanom Ghebreyesus said.

He called the situation “very worrying” and said a coordinated international response is “essential” to stop the outbreaks and save lives.

The UN health agency's decision comes a day after the African Union's health watchdog declared its own public health emergency over the growing outbreak.

“The emergence last year and rapid spread of clade 1b in DRC, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring DRC is especially concerning,” Tedros said.

Dimie Ogoina, who chaired the emergency committee, said the 15 members present unanimously thought the mpox upsurge was an extraordinary event.

He said many members feared the known situation in Africa was “actually the tip of the iceberg”, because without more robust surveillance, “we don't have the full picture”.

Maria Van Kerkhove, the WHO's epidemic and pandemic preparedness and prevention director, insisted: “We can stop transmission of mpox with a concerted effort.”

Two vaccines for mpox are recommended by WHO immunisation experts.

Previously called monkeypox, the virus was first discovered in humans in 1970 in what is now the DRC.

Mpox is an infectious disease caused by a virus transmitted to humans by infected animals but can also be passed from human to human through close physical contact.

The disease causes fever, muscular aches and large boil-like skin lesions.

In May 2022, mpox infections surged worldwide, mostly affecting gay and bisexual men, due to the clade 2b subclade.

The WHO declared a public health emergency which lasted from July 2022 to May 2023. The outbreak, which has now largely subsided, caused some 140 deaths out of around 90,000 cases.

But the new clade 1b subclade, which has been surging in the DRC since September 2023, causes more severe disease than clade 2b. The former also has a higher fatality rate.

A public health emergency has only been declared seven times since 2009 over: H1N1 swine flu, polio virus, Ebola, Zika virus, Ebola again, COVID-19 and mpox.

At the end of July, the European Centre for Disease Prevention and Control deemed the risk of an mpox outbreak in the EU to be “very low”.

“I would like to stress that the risk to the EU/EEA population from the new mpox variant identified in DRC remains very low. ECDC is engaging with our partners in Africa in their efforts to contain this outbreak for the benefit of all those affected, prevent this new variant from spreading any further and reinforce future preparedness and response capabilities,” Pamela Rendi-Wagner, Director of ECDC had said.

The ECDC also noted that despite concerns about the new severity of the new variant, current vaccines and treatments were expected to remain effective.

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