WHO Declares Mpox Outbreaks in Africa a Global Health Emergency

LONDON — The World Health Organization has declared the mpox outbreaks in Congo and elsewhere in Africa a global health emergency, citing confirmed cases among children and adults in more than a dozen countries and the spread of a new form of the virus. Limited vaccine doses are available on the continent.

Earlier this week, the Africa Centers for Disease Control and Prevention announced that the mpox outbreaks were a public health emergency, reporting over 500 deaths, and called for international assistance to curb the virus’ spread.

“This is a situation that should concern us all … The potential for further spread beyond Africa and beyond is very worrying,” stated WHO director-general Tedros Adhanom Ghebreyesus.

The Africa CDC previously reported that mpox, also known as monkeypox, has been detected in 13 countries this year, with over 96% of all cases and deaths occurring in Congo. Case numbers have increased by 160% and deaths by 19% compared to the same period last year. To date, there have been more than 14,000 cases and 524 fatalities.

“We are now facing a situation where (mpox) poses a risk to many more neighboring countries in and around central Africa,” said Salim Abdool Karim, a South African infectious diseases expert who chairs the Africa CDC emergency group. He pointed out that the new version of mpox originating from Congo appears to have a fatality rate of around 3-4%.

During the global 2022 mpox outbreak that affected over 70 countries, less than 1% of individuals succumbed to the disease.

Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, asserted that declaring the mpox outbreaks in Africa an emergency is justified if it might lead to increased support to contain them.

“It’s a failure of the global community that things had to get this bad to release the necessary resources,” he stated.

Officials at the Africa CDC reported that nearly 70% of cases in Congo are in children under the age of 15, who also represent 85% of deaths.

Jacques Alonda, an epidemiologist working in Congo with international charities, expressed concern about the spread of mpox in refugee camps in the country’s conflict-ridden eastern region.

“The most severe case I’ve witnessed involved a six-week-old baby who was only two weeks old when he contracted mpox,” Alonda shared, adding that the baby has been under their care for a month. “He became infected because of hospital overcrowding, which forced him and his mother to share a room with someone else who had the virus, which was undiagnosed.”

Save the Children stated that Congo’s healthcare system had already been “collapsing” under the strain of malnutrition, measles, and cholera.

WHO Director-General Tedros Adhanom Ghebreyesus indicated that officials are confronting numerous mpox outbreaks in various countries with “different modes of transmission and different levels of risk.”

The U.N. health agency revealed that mpox was recently identified for the first time in four East African countries: Burundi, Kenya, Rwanda, and Uganda. All of these outbreaks are linked to the one in Congo. In the Ivory Coast and South Africa, health authorities have reported outbreaks of a different and less dangerous version of mpox that spread worldwide in 2022.

Unlike in previous mpox outbreaks, where lesions were primarily observed on the chest, hands, and feet, the new form presents milder symptoms and lesions on the genitals. This makes it harder to detect, meaning individuals might also infect others without realizing they are infected.

In 2022, WHO declared mpox to be a global emergency after it spread to over 70 countries that had not previously reported mpox, primarily affecting gay and bisexual men. Before that outbreak, the disease had mainly been observed in sporadic outbreaks in central and West Africa when people came into close contact with infected wild animals.

Western countries largely contained the spread of mpox with the help of vaccines and treatments, but very few of these have been available in Africa.

Marks of the London School of Hygiene and Tropical Medicine suggested that in the absence of mpox vaccines licensed in the West, officials could consider vaccinating people against smallpox, a related disease. “We require a large supply of vaccine so that we can vaccinate populations most at risk,” he stated, adding that this would include sex workers, children, and adults living in outbreak regions.

Congolese authorities reported requesting 4 million doses of mpox vaccine, according to Cris Kacita Osako, coordinator of Congo’s Monkeypox Response Committee, in an interview with The Associated Press. Osako mentioned that these doses would primarily be used for children under 18.

“The United States and Japan are the two countries that have positioned themselves to provide vaccines to our country,” Osako said.

Although WHO’s emergency declaration aims to stimulate action from donor agencies and countries, the global response to previous emergency designations has been mixed.

Dr. Boghuma Titanji, an infectious diseases expert at Emory University, stated that the last WHO emergency declaration for mpox “did very little to move the needle” on securing essential resources such as diagnostic tests, medicines, and vaccines for Africa.

“The world has a real opportunity here to act in a decisive manner and not repeat past mistakes, (but) that will take more than an (emergency) declaration,” Titanji said.

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Associated Press writers Gerald Imray in Cape Town, South Africa, Christina Malkia in Kinshasa, Congo and Mark Banchereau in Dakar, Senegal contributed to this report.