WHO Declares Mpox Outbreaks in Africa a Global Health Emergency

The World Health Organization (WHO) has declared the rising spread of mpox in Africa a global health emergency, cautioning that the virus might eventually cross international borders. WHO director-general Tedros Adhanom Ghebreyesus made this announcement following a meeting of the UN health agency's emergency committee. The Africa Centers for Disease Control and Prevention (CDC) had already declared mpox a public health emergency on the continent.

Mpox Outbreak in Africa

This year, Africa has reported over 14,000 cases and 524 deaths due to mpox, surpassing last year's figures. A significant concern is that more than 96% of these cases and deaths are concentrated in Congo. Scientists are worried about a new variant of the disease in Congo that may be more easily transmitted among people.

Mpox, also known as monkeypox, was first identified in 1958 when scientists observed outbreaks of a "pox-like" disease in monkeys. Until recently, most human cases were found in central and West Africa among those who had close contact with infected animals. In 2022, the virus was confirmed to spread through sexual contact for the first time, leading to outbreaks in over 70 countries that had not previously reported mpox.

Current Situation and Concerns

The number of mpox cases has surged significantly. The Africa CDC reported that mpox is now present in at least 13 African countries. Compared to the same period last year, cases have increased by 160%, and deaths have risen by 19%. Earlier this year, scientists identified a new form of mpox in a Congolese mining town that can kill up to 10% of those infected and may spread more easily.

WHO recently detected mpox for the first time in four East African countries: Burundi, Kenya, Rwanda, and Uganda. All these outbreaks were linked to the epidemic in Congo. Tedros expressed concern about the potential further spread of the disease within Africa and beyond. In Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread globally in 2022.

Emergency Declaration Implications

The WHO's emergency declaration aims to prompt donor agencies and countries into action. However, global responses to previous declarations have been mixed. Dr Jean Kaseya, Director General of Africa CDC, stated that their declaration was intended "to mobilize our institutions, our collective will and our resources to act swiftly and decisively." He called for international assistance, noting that Africa's escalating caseload had been largely ignored.

Michael Marks from the London School of Hygiene and Tropical Medicine said, "It's clear that current control strategies aren't working and there is a clear need for more resources." He added that if a global emergency declaration is necessary to unlock these resources, then it is justified.

Differences from the 2022 Outbreak

During the global mpox outbreak in 2022, gay and bisexual men constituted most cases, with the virus spreading mainly through close contact, including sex. In Africa, children under 15 now account for over 70% of mpox cases and 85% of deaths in Congo. Tedros mentioned that officials are dealing with several mpox outbreaks with "different modes of transmission and different levels of risk."

Greg Ramm from Save the Children expressed concern about mpox spreading in crowded refugee camps in eastern Congo. He noted there were 345,000 children "crammed into tents in unsanitary conditions," adding that Congo's health system was already strained by malnutrition, measles, and cholera.

Dr Boghuma Titanji from Emory University said it is unclear why children are disproportionately affected by mpox in Congo. She suggested it might be due to children's higher susceptibility to the virus or social factors like overcrowding and exposure to infected parents.

Possible Solutions

The 2022 global mpox outbreak was largely controlled using vaccines and treatments in wealthy countries and encouraging people to avoid risky behaviour. However, few vaccines or treatments have been available in Africa. Marks suggested immunisation could help control the outbreak, including vaccinating people against smallpox, a related virus.

"We need a large supply of vaccine so that we can vaccinate populations most at risk," he said, highlighting sex workers, children, and adults living in outbreak regions as priorities. Congo is negotiating with donors for possible vaccine donations and has received some financial aid from Britain and the US.

WHO has already allocated $1.45 million from its emergency fund to support the response to mpox in Africa but stated it needs an initial $15 million to fund this response effectively.