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WHO chief overrules panel to declare monkeypox global emergency

World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus on Dec. 20, 2021, at the WHO headquarters in Geneva. (Fabrice Coffrini/AFP/Getty Images/TNS)

The monkeypox outbreak is a public health emergency of international concern, the head of the World Health Organization said, overruling a divided expert panel to issue the group’s highest alert.

The move paves the way for stepped-up global cooperation to stop the virus, which has spread to dozens of countries. The last time the WHO made a similar declaration was during the early stages of the COVID-19 outbreak in January 2020.

Director-General Tedros Adhanom Ghebreyesus personally intervened after nine members of the expert committee were against declaring the monkeypox outbreak an emergency, while six were in favor. Tedros and the health organization had faced criticism in some quarters that they acted too slowly to ratchet up the alarms on COVID.

“We have an outbreak that has spread around the world rapidly through new modes of transmission,” he said during a press briefing in Geneva on Saturday.

A PHEIC — pronounced “fake” — applies to an extraordinary event that carries a public-health risk via the international spread of a disease, and one that potentially requires a coordinated response. It can be used to encourage nations to cooperate on countermeasures, while letting the agency recommend steps such as travel advisories.

US response

On Friday, U.S. health officials told reporters they’ve been weighing a similar declaration, which would ultimately come from the U.S. Department of Health and Human Services.

“Certainly it’s a conversation that’s ongoing,” Ashish Jha, the White House COVID response coordinator said. “We’re looking at that, looking at what are the ways in which the response could be enhanced by declaring a public health emergency.”

A cousin of the smallpox virus, monkeypox has mostly been confined to developing countries for years, but has spread across Europe and the U.S. in recent months.

The WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in Europe where it is high, Tedros said.

The pathogen typically causes flu-like symptoms, followed by a rash that often starts on the face and spreads down the belly. The illness often lasts for two weeks to a month, and can be deadly.

The WHO said there are about 16,000 confirmed cases across 75 countries and regions, although most cases are from Europe. Five deaths have been recorded in Africa, the agency said.

A large number of cases occurred in people between the ages of 31 to 40, and the majority of them were in male patients, the WHO said.

Three criteria

Tedros said monkeypox outbreak met the three criteria for declaring a public health emergency of international concern under the International Health Regulations.

A large proportion of cases have been among men who’ve had sex with men, and many have occurred within sexual networks, though anyone can contract the disease. The U.K. government recently expanded the provision of the smallpox vaccine Imvanex, which is shown to be effective against monkeypox, to some at-risk gay and bisexual men to help control the spread. The EU has also approved Imvanex to target monkeypox.

“This is an outbreak that’s concentrated among men who have sex with men, especially those with multiple sexual partners,” Tedros said. “That means that this is an outbreak that can be stopped with the right strategies in the right groups.”

The WHO recommended that nations implement a coordinated response to stop transmission and protect vulnerable groups by offering international travel recommendations; intensifying surveillance and public health measures; and accelerating research into vaccines, therapeutics and other tools, among other recommendations.

“We believe this will mobilize the world to act together. It needs not only coordination but solidarity,” Tedros said.

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