Pathogen Pulse: WHO Declares Global Health Emergency as Mpox Outbreak Spreads Across Africa

Pathogen Pulse with Isis Lamphier, MPH, CIC

On August 14, 2024, the World Health Organization (WHO) declared a global health emergency in response to the rapid resurgence of mpox, formerly known as monkeypox, in the Democratic Republic of the Congo (DRC) and several other African countries. The escalating outbreak has caused widespread concern due to the virus's rapid spread and increasing infection rates across the region. WHO's declaration underscores the urgency of addressing this serious public health threat and calls for swift global action to prevent further transmission, both within Africa and beyond.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus cited the surge in mpox cases in the DRC and neighboring African countries as a Public Health Emergency of International Concern (PHEIC), a designation reserved for serious health risks with potential global consequences. This determination followed recommendations from an independent emergency committee, which reviewed outbreak data and raised alarms about the virus's potential to spread further across Africa and beyond.

Dr. Tedros emphasized the need for a coordinated international response, noting the emergence of a new strain of mpox in eastern DRC, clade 1b, which has rapidly spread through sexual networks. The growing number of cases in Kenya, Uganda, Rwanda, and Burundi is particularly concerning, with more than 15,600 cases and 537 deaths reported this year. Dr. Tedros warned that immediate global intervention is necessary to prevent a repeat of the 2022 mpox outbreak.

In response to mpox trends and to assist prevention efforts, the Association for Professionals in Infection Control and Epidemiology (APIC) has released a comprehensive Mpox Playbook aimed at guiding healthcare workers, infection preventionists, and public health authorities in managing and controlling the outbreak. The playbook offers best practices, tools, and strategies for preventing mpox transmission in healthcare settings and communities, as well as protocols for vaccine administration, case tracking, and outbreak communication.

APIC's playbook is designed to help healthcare facilities improve preparedness and response measures, particularly in high-risk areas like the DRC and its neighboring countries. It includes critical insights on infection control procedures, personal protective equipment (PPE) guidelines, and testing protocols to minimize spread in both healthcare and community environments.

In collaboration other global partners, WHO is mobilizing resources to contain the outbreak. This includes efforts to increase vaccine access, particularly in lower-income countries, through the Emergency Use Listing process, which allows vaccines to be rapidly distributed in regions that have yet to receive regulatory approval. Vaccine donations are being coordinated, and emergency funding has been released to support surveillance and containment measures.

So far, WHO has allocated $1.45 million from its Contingency Fund for Emergencies, but estimates $15 million will be needed to address the outbreak initially. These funds will support not only vaccine distribution but also expanded testing, treatment, and public health outreach.

This PHEIC declaration is the second in two years related to mpox. The virus, which is endemic to central and west Africa, was initially detected in humans in 1970 but gained global attention during the 2022 outbreak. That outbreak, driven primarily by sexual transmission, was declared over in May 2023 after a sustained decline in cases. However, the current resurgence demonstrates the virus’s capacity to reemerge and spread rapidly.

Dr. Matshidiso Moeti, WHO Regional Director for Africa, highlighted the significant ongoing efforts in partnership with local governments and communities to curb the outbreak. However, she noted that the scale of the current spread requires stronger international support.

As health experts push for urgent action, the global community is being reminded of the importance of timely and effective intervention. With the lessons learned from the 2022 mpox outbreak, the coordinated efforts of WHO, APIC, and international health authorities are now focused on containing the virus and prevention worldwide.