Monkeypox officially becomes a global emergency

The expanding Outbreak of monkeypox in more than 70 countries is an “extraordinary” situation qualifying as a global emergency, the World Health Organization chief said Saturday, a statement that could spur further investment in treating the once-rare disease and exacerbate the fight for scarce vaccines.

A global emergency is the WHO’s highest alert level, but the designation doesn’t necessarily mean a disease is particularly communicable or deadly. Similar statements were made in Latin America in 2016 for the Zika virus and ongoing polio eradication efforts, and for the COVID-19 pandemic and 2014 Ebola outbreak in West Africa.

WHO Director-General Tedros Adhanom Ghebreyesus made the decision to classify monkeypox as a global emergency despite lack of consensus among experts on the UN health agency’s Emergency Committee, saying he acted as a “tiebreaker”. It was the first time that a chief of the UN health agency made such a decision unilaterally without expert advice.

“We have an outbreak that has spread rapidly around the world through new modes of transmission that we understand too little about,” Tedros said. “I know this has not been an easy or straightforward process and that there are different views.”

dr Michael Ryan, WHO’s chief of emergencies, said the director-general had declared monkeypox a global emergency to ensure the world was taking the current outbreaks seriously.

Although monkeypox has been common in parts of central and west Africa for decades, it was not known to trigger large outbreaks across the continent or spread widely among humans until authorities discovered dozens of epidemics in Europe, North America and elsewhere in May.

Last month, the WHO Expert Committee said the monkeypox outbreak did not yet constitute an international emergency, but the panel met this week to reassess the situation.

According to the US Centers for Disease Control and Prevention, more than 16,000 cases of monkeypox have been reported in 74 countries since around May. So far, deaths from monkeypox have only been reported in Africa, where a more dangerous version of the virus is spreading, mainly in Nigeria and Congo.

In Africa, monkeypox spreads primarily through infected wild animals, such as rodents, in limited outbreaks that have not usually crossed borders. However, in Europe, North America and elsewhere, monkeypox is spreading among people who have no connection to animals or who have recently traveled to Africa.

The WHO’s leading monkeypox expert, Dr. Rosamund Lewis said this week that 99% of all monkeypox cases outside of Africa have been in men, and 98% of those have been in men who have sex with men. Experts suspect the monkeypox outbreaks in Europe and North America were spread through sex at two raves in Belgium and Spain.

“Although I am declaring a public health emergency of international concern right now, this is an outbreak focused on men who have sex with men, particularly those with multiple sexual partners,” Tedros said. “That means this is an outbreak that can be stopped with the right strategies.”

The UK recently downgraded its assessment of monkeypox after seeing no evidence of widespread transmission through men who are gay, bisexual or having sex with other men and noting the disease does not spread easily or cause serious illness.

The US Centers for Disease Control and Prevention said it “supported” the WHO’s emergency declaration and hoped it would spur international action to combat the outbreaks. The US has reported more than 2,800 cases of monkeypox and has sent more than 370,000 doses of vaccine to US states that report cases.

Some experts had questioned whether such an explanation would help, arguing that the disease was not serious enough to deserve attention and that rich countries fighting monkeypox already had the means to do so. Most people recover without medical help, although the lesions can be painful.

Michael Head, a senior research fellow in global health at Southampton University, said the WHO emergency declaration could help donors like the World Bank allocate funds to halt the outbreaks in both the West and Africa.

In the US, some experts have speculated that monkeypox may be on the verge of becoming an established sexually transmitted disease in the country, like gonorrhea, herpes and HIV.

“The bottom line is that we have seen a shift in the epidemiology of monkeypox, where there is now widespread, unexpected transmission,” said Dr. Albert Ko, Professor of Public Health and Epidemiology at Yale University. “There are some genetic mutations in the virus that suggest why this might be happening, but we need a globally coordinated response to get it under control.”

Ko called for an immediate expansion of testing and said there were significant monitoring gaps.

“The cases we’re seeing are just the tip of the iceberg,” he said. “The window has probably closed for us to quickly halt outbreaks in Europe and the US, but it’s not too late to prevent monkeypox from wreaking havoc in poorer countries without the resources to deal with it.” serve.”

WHO’s Tedros called on the world to “collaborate in solidarity” on the distribution of treatments, tests and vaccines. for monkeypox. The UN agency has previously said it is working to create a vaccine-sharing mechanism for the hardest-hit countries, but gave few details on how it might work. Unlike the numerous companies that have manufactured COVID-19 vaccines, there is only one manufacturer for the monkeypox vaccine, Denmark’s Bavarian Nordic.

dr Placide Mbala, a virologist who heads the global health division at Congo’s Institute of National Biomedical Research, said he hopes all global efforts to tackle monkeypox are fair. Although countries like the UK, Canada, Germany and the US have ordered millions of doses of monkeypox vaccine, none have gone to Africa.

“The solution must be global,” Mbala said, adding that any vaccines sent to Africa would be used for those most at risk, such as hunters in rural areas.

“Vaccination in the west could help stop the outbreak there, but there will still be cases in Africa,” he said. “If the problem is not solved here, the risk remains for the rest of the world.”