WHO Declares Monkeypox As Global Public Health Emergency

The World Health Organization (WHO) on Saturday declared the international Monekypox outbreak as "public health emergency of international concern". 

Monkeypox has been detected in more than 70 countries in the current outbreak, which the WHO called an "extraordinary" situation. The WHO's declaration could spur further investment in treating the once-rare disease and worsen the scramble for vaccines that are already scarce.

WHO Director-General Tedros Adhanom Ghebreyesus made the declaration despite a lack of consensus among members of WHO's Emergency Committee. It was the first time the WHO chief has taken such an action.

Tedros said, "In short, we have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little and which meets the criteria in the international health regulations. I know this has not been an easy or straightforward process and that there are divergent views among the members."

Although Monkeypox has been established in parts of central and west Africa for decades, it was not known to spark large outbreaks beyond the continent or to spread widely among people until May when authorities detected dozens of epidemics in Europe, North America and elsewhere.

Declaring a global emergency means the Monkeypox outbreak is an "extraordinary event" that could spill over into more countries and requires a coordinated global response.

WHO previously declared emergencies for public health crises such as the Covid-19 pandemic, the 2014 West African Ebola outbreak, the Zika virus in Latin America in 2016 and the ongoing effort to eradicate polio.

The emergency declaration mostly serves as a plea to draw more global resources and attention to an outbreak. Past announcements had mixed impact, given that WHO is largely powerless in getting countries to act.

Last month, WHO's expert committee said the worldwide Monkeypox outbreak did not yet amount to an international emergency, but the panel convened this week to reevaluate the situation.

More than 16,000 cases of Monkeypox have been reported in 74 countries since about May, according to the U.S. Centers for Disease Control and Prevention.

To date, Monkeypox deaths have only been reported in Africa, where a more dangerous version of the virus is spreading, mainly in Nigeria and Congo.

In Africa, Monkeypox mainly spreads to people from infected wild animals like rodents in limited outbreaks that typically have not crossed borders.

In Europe, North America and elsewhere, however, Monkeypox is spreading among people with no links to animals or recent travel to Africa.

WHO's top monkeypox expert, Dr. Rosamund Lewis, said this week that 99 per cent of all the Monkeypox cases beyond Africa were in men and that of those, 98 per cent involved men who have sex with men. Experts suspect the Monkeypox outbreaks in Europe and North America were spread via sex at two raves in Belgium and Spain.

Dr David Heymann, who formerly headed WHO's emergencies department, described the current outbreak to AP in an interview in May as "a random event". He added that the leading theory to explain the spread of the disease was sexual transmission among gay and bisexual men at two raves. 

He said, "We know monkeypox can spread when there is close contact with the lesions of someone who is infected, and it looks like sexual contact has now amplified that transmission."

Michael Head, a senior research fellow in global health at Southampton University, said it was surprising WHO hadn't already declared Monkeypox a global emergency, explaining that the conditions were arguably met weeks ago.

Some experts have questioned whether such a declaration would help, arguing the disease isn't severe enough to warrant the attention and that rich countries battling Monkeypox already have the funds to do so. Most people recover without needing medical attention, although the lesions may be painful.

Head said, I think it would be better to be proactive and overreact to the problem instead of waiting to react when it's too late."

He added that WHO's emergency declaration could help donors like the World Bank make funds available to stop the outbreaks both in the West and in Africa, where animals are the likely natural reservoir of monkeypox.

Yale University's Dr. Albert Ko said, "The bottom line is we've seen a shift in the epidemiology of Monkeypox where there's now widespread, unexpected transmission. There are some genetic mutations in the virus that suggest why that may be happening, but we do need a globally-coordinated response to get it under control."

Ko called for testing to be immediately scaled up rapidly, saying that similar to the early days of Covid-19, that there were significant gaps in surveillance.

"The cases we are seeing are just the tip of the iceberg. The window has probably closed for us to quickly stop the outbreaks in Europe and the US, but it's not too late to stop Monkeypox from causing huge damage to poorer countries without the resources to handle it," said Ko, a professor of public health and epidemiology at Yale University.

In the United States, some experts have speculated that Monkeypox might become entrenched there as the newest sexually transmitted disease, like gonorrhea, herpes and HIV. Officials estimate that 1.5 million men are at high risk of being infected.

Dr. Placide Mbala, a virologist who directs the global health department at Congo's Institute of National Biomedical Research, said he hoped any global efforts to stop Monkeypox would be equitable.

Although countries including Britain, Canada, Germany and the United States have ordered millions of vaccine doses, none have gone to Africa.

He said the solution needs to be global. He added that any vaccines sent to Africa would be used to target those at highest risk, like hunters in rural areas.

Mbala further said, "Vaccination in the West might help stop the outbreak there, but there will still be cases in Africa. Unless the problem is solved here, the risk to the rest of the world will remain."

(With AP inputs)