GENEVA, Switzerland – The World Health Organization, WHO, on Wednesday, August 12, 2024, declared the ongoing mpox outbreak in Africa a global health emergency, the highest level of international health alert.
This followed a similar declaration made by the Africa Centres for Disease Control and Prevention the previous day, underscoring the severity of the situation on the continent.
A deadlier strain of the virus, known as clade Ib, has rapidly spread in the Democratic Republic of Congo (DRC) and reached at least four previously unaffected African nations.
WHO Director-General Tedros Adhanom Ghebreyesus expressed grave concerns about the potential for further international spread, calling the situation “very worrying.”
“It was unanimous that the current outbreak of mpox, the upsurge of mpox, is an extraordinary event,” said Dimie Ogoina, chair of WHO’s emergency committee.
“What we have in Africa is the tip of the iceberg. … We are not recognizing, or we don’t have the full picture of, this burden of mpox.”
What Is Mpox?
Formerly known as monkeypox, mpox is a viral disease related to smallpox, though typically less severe. It spreads through close contact, including touching, kissing, or sex, as well as through contaminated materials like clothing or needles.
Initial symptoms resemble the flu, followed by a painful or itchy rash that scabs over and resolves within weeks.
A Dangerous New Strain
Mpox is split into two genetic clades: Clade I and Clade II. The current outbreak is driven by clade I, specifically subtype Ib, which is known to cause more severe disease.
Clade II, responsible for a global outbreak from 2022 to 2023, is less dangerous, with a fatality rate under 0.2%.
In contrast, clade I outbreaks have killed up to 10% of those infected, though recent outbreaks show lower death rates.
Experts note that clade Ib appears to be a new mutation adapted to human transmission, which has compounded the public health crisis.
“We are not dealing with one outbreak of one clade; we are dealing with several outbreaks of different clades in different countries with different modes of transmission and different levels of risk,” said Tedros.
Geographic Spread and International Concerns
Previously, mpox was primarily found in Central and West Africa. However, the virus has now spread to 13 African countries and recently reached Sweden, marking the first time clade I mpox has been identified outside of Africa.
The spread of the disease to new countries and regions has raised alarms globally, particularly given the increase in international travel.
The majority of mpox cases remain concentrated in the DRC, but the rising number of cases in previously unaffected nations is a key factor in the WHO’s decision to declare the outbreak a global health emergency.
Containing the Spread
While vaccines for mpox are available, they are not widely accessible in Africa.
The Vaccine Alliance (Gavi) has committed up to $500 million to supply mpox vaccines to affected countries, including the DRC, and plans to establish a global stockpile by 2026.
The WHO has approved the Emergency Use Listing for mpox vaccines and has developed a regional response plan requiring $15 million in funding, with half a million vaccine doses already in stock.
However, WHO officials emphasised that vaccines alone are not enough. Containing the outbreak will also require enhanced surveillance, diagnostic efforts, and research to close critical knowledge gaps.
Tim Nguyen of WHO’s Health Emergencies Program noted that another 2.4 million vaccine doses could be produced by year’s end, with the DRC and Nigeria set to receive initial supplies.
A Call for Urgent Action
With the WHO’s declaration of a global health emergency, international health authorities ramped up efforts to prevent the further spread of mpox.
“No one is safe until everyone is safe,” said Dr. Daniel Bausch, senior adviser for global health security at FIND, stressing the importance of swift global action.
As the virus spreads, vulnerable populations—including infants, immunocompromised individuals, and pregnant women—are at heightened risk of severe disease, amplifying the need for a coordinated and well-resourced global response.
WHO Approves First Mpox Vaccine
The World Health Organization, WHO, has added the first mpox vaccine to its prequalification list, a significant milestone in the fight against the virus as outbreaks surge across Africa.
The WHO declared mpox, formerly known as monkeypox, a “public health emergency of international concern” in August as the virus continues to spread rapidly, particularly in the Democratic Republic of the Congo (DRC).
At least 14 African countries have reported mpox outbreaks this year, with more than 17,000 suspected cases and 724 confirmed deaths since the start of 2024, according to the Africa Centres for Disease Control and Prevention (CDC).
The DRC has been the hardest hit, accounting for over 96% of all cases and deaths, with children being disproportionately affected.
The newly approved vaccine, MVA-BN, produced by Bavarian Nordic A/S, is the first mpox vaccine to receive WHO prequalification.
In the U.S., it is marketed under the brand name JYNNEOS, and over 1 million doses have been administered in the country since the 2022 mpox outbreak.
The WHO prequalification system, established in 1987, ensures vaccines are safe, effective, and suitable for use in low- and middle-income countries.
WHO Director-General Dr Tedros Ghebreyesus hailed the approval as a critical step in addressing both the current African outbreaks and future threats.
“We now need urgent scale-up in procurement, donations, and rollout to ensure equitable access to vaccines where they are needed most,” Ghebreyesus said in a statement.
Additional reporting by Ima Matthew.
