WHO Director-General Dr. Tedros Adhanom Ghebreyesus has declared the recent surge of mpox cases in the Democratic Republic of the Congo (DRC) and other African countries as a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005) (IHR).
This declaration follows the advice of an IHR Emergency Committee, composed of independent experts who reviewed data from WHO and affected countries. The Committee advised that the mpox outbreak poses a significant risk of further spread across Africa and potentially beyond.
In response to the PHEIC, Dr. Tedros stated, “The emergence of a new mpox clade, its rapid spread in eastern DRC, and cases reported in neighboring countries are deeply concerning. Alongside other ongoing outbreaks, it is clear that a coordinated international effort is essential to contain these outbreaks and save lives.”
Dr. Matshidiso Moeti, WHO Regional Director for Africa, emphasized the ongoing efforts in collaboration with communities and governments to control the virus. “With the virus spreading further, we are stepping up international action to help countries bring these outbreaks under control,” she said.
Professor Dimie Ogoina, Chair of the Emergency Committee, stressed the global implications of the outbreak. “The current rise in mpox cases, along with the spread of a new sexually transmissible strain, is a serious emergency not just for Africa but for the entire world. Mpox was neglected in Africa, leading to a global outbreak in 2022. We must act decisively to prevent a recurrence,” he urged.
This is the second PHEIC related to mpox in two years. Mpox, caused by the Orthopoxvirus, was first identified in humans in 1970 in the DRC and is endemic to central and west Africa. The multi-country outbreak in July 2022 was declared a PHEIC as the virus spread rapidly through sexual contact in countries where it had not previously been detected. That PHEIC was lifted in May 2023 after global cases declined significantly.
Mpox has been present in the DRC for over a decade, with a steady increase in cases reported each year. Last year saw a significant rise in cases, and this year’s numbers have already surpassed last year’s total, with more than 15,600 cases and 537 deaths.
The emergence of a new strain, clade 1b, which appears to be spreading mainly through sexual networks, and its detection in neighboring countries, is particularly alarming and a key factor in the PHEIC declaration.
In the past month, over 100 laboratory-confirmed cases of clade 1b have been reported in Burundi, Kenya, Rwanda, and Uganda—countries that had not previously reported mpox. Experts believe the actual number of cases is higher, as many clinically compatible cases have not been tested.
The WHO Strategic Advisory Group of Experts on Immunization has recommended two vaccines for mpox, which are also approved by national regulatory authorities in countries like Nigeria and the DRC. Last week, the Director-General initiated the process for Emergency Use Listing for mpox vaccines to accelerate access for lower-income countries. This will also enable partners like Gavi and UNICEF to procure and distribute vaccines.
WHO is coordinating with countries and vaccine manufacturers on potential vaccine donations and is working through the interim Medical Countermeasures Network to ensure equitable access to vaccines, treatments, diagnostics, and other resources.
To support surveillance, preparedness, and response activities, WHO estimates an immediate funding need of US$ 15 million. The organization has already released US$ 1.45 million from its Contingency Fund for Emergencies and may need to allocate more in the coming days. WHO is appealing to donors to fully fund the mpox response.
