WHO declares monkeypox a global emergency

More than 70 countries have had cases of a disease previously seen only rarely outside Africa

The World Health Organisation has declared that the rapidly expanding monkeypox outbreak now qualifies as a global emergency.

WHO Director General Dr Tedros Adhanom Ghebreyesus described the spread of the disease, which is now in more than 70 countries, as an “extraordinary” situation.

He made the decision to issue the alert despite a lack of consensus among experts serving on the UN health agency's emergency committee. It is the first time the chief of the UN health agency has taken such action.

“We have an outbreak that has 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,” Dr Tedros said.

“I know this has not been an easy or straightforward process and that there are divergent views among the members” of the committee, he said.

Declaring a global emergency means the WHO fears the monkeypox outbreak could spill over into more countries and requires a co-ordinated response.

About 65 countries, where monkeypox is not endemic, have reported outbreaks of the viral disease.

It is a cousin of the smallpox virus, and has been mostly confined to developing countries until the last few months, when it spread across Europe and the US.

Human monkeypox was first identified in 1970 in what is now the Democratic Republic of Congo in a 9-year-old boy. It became endemic in the tropical rainforests of central and west Africa, where 11 countries reported cases.

In June 2003, the disease was reported in the US, the first time it had been detected outside Africa.

Announcing his decision to declare the health emergency, Dr Tedros said the committee had failed to reach a consensus, with nine members against and six in favour of the declaration.

Previously, Dr Tedros has typically endorsed expert committee recommendations, but the sources said it was likely he had decided to back the highest alert level because of concerns about escalating case numbers and a short supply of vaccines and treatments, despite the lack of a majority opinion.

Dr Placide Mbala, who directs the global health department at Congo’s Institute of National Biomedical Research, said he hoped any global efforts to stop monkeypox would be equitable.

“The solution needs to be global,” Dr Mbala said. “Vaccination in the West might help stop the outbreak there, but there will still be cases in Africa. Unless the problem is solved here, the risk to the rest of the world will remain.”

Monkeypox emergency

The WHO previously declared emergencies for public health crises such as the coronavirus pandemic, the 2014 West African Ebola outbreak, the Zika virus in Latin America in 2016 and the continuing effort to eradicate polio.

Last month, the UN agency’s expert committee said the worldwide monkeypox outbreak did not yet amount to an international emergency, but the panel convened this week to re-evaluate the situation.

More than 16,000 cases of monkeypox have been reported in 74 countries since about May, figures compiled by the US Centres for Disease Control and Prevention show.

The UAE recorded three new cases of monkeypox on Sunday, taking its total number of infections to 16. India also recorded its fourth known case on Sunday.

To date, monkeypox deaths have only been reported in Africa, where a more dangerous version of the virus is spreading, mainly in Nigeria and the Democratic Republic of Congo.

In Africa, monkeypox mainly spreads to people from infected wild animals such as rodents, in limited outbreaks that typically have not crossed borders.

In Europe, North America and elsewhere, however, monkeypox is spreading among people with no links to animals or recent travel to Africa.

The WHO’s top monkeypox expert, Dr Rosamund Lewis, said this week that 99 per cent of all the monkeypox cases beyond Africa were in men and that of those, 98 per cent involved men who have sex with men.

Experts suspected the monkeypox outbreaks in Europe and North America were spread by people who attended two raves in Belgium and Spain.

Michael Head, a senior research fellow in global health at Southampton University, said it was surprising that the WHO had not already declared monkeypox a global emergency, since the conditions were arguably met weeks ago.

Some experts have questioned whether such a declaration would help, saying the disease is not severe enough to warrant the attention and that rich countries battling monkeypox already have the funds to do so.

Most people recover without needing medical attention, although the lesions may be painful.

“I think it would be better to be proactive and overreact to the problem instead of waiting to react when it’s too late,” Mr Head said.

He added that the WHO’s emergency declaration could enable donors such as the World Bank to make funds available to stop the outbreaks both in the West and in Africa.