WHO says monkeypox is not yet a global health emergency – but expresses “serious concerns” about the spread

top line

The World Health Organization announced on Saturday that the spread of monkeypox is not yet a public health emergency, but WHO Director-General Tedros Adhanom Ghebreyesus said “serious concerns about the scale and speed of the current outbreak” remain.

Important facts

A WHO panel made the decision at an emergency meeting convened to determine whether the escalating spread of monkeypox qualifies as a public health emergency of international concern (PHEIC), which would urge countries to take action to limit the spread of the disease to seize virus.

The committee noted that most cases of monkeypox during the recent surge were confined to communities of “gay, bisexual and other men who have sex with men” who are not vaccinated against smallpox, but cautioned that “the There is a risk of further, sustained transmission to the wider population that should not be overlooked.”

The committee’s decision was not unanimous, but its members reached consensus on their decision, according to the WHO, which listed several scenarios that would trigger another emergency reconsideration meeting.

An increase in the case growth rate over the next 21 days, signs of “significant spread to and within additional countries” and an increase in the severity of cases are among the reasons why the panel would meet again.

Crucial quote

“This is clearly an evolving health threat that my colleagues and I at the WHO Secretariat are following extremely closely,” Tedros said in a statement.

key background

A PHEIC is the highest WHO alert level possible under international law. It aims to alert countries to take immediate action to stop an outbreak and provide guidance on what actions they should take to achieve that. It is also a signal for nations to activate their own contingency plans, such as B. increasing funding, vaccinations or tests. Gian Luca Burci, professor of international law and former legal adviser to the WHO, said forbes a declaration can provide “a convenient political cover” for national politicians to implement potentially unpopular policies. Under international law, nations are expected to take steps to address a PHEIC, although they are not compelled to act – it took many nations weeks to respond after the WHO sounded the Covid-19 alert in January 2020. Clare Wenham, Associate Professor of Global Health Policy at the London School of Economics and Political Science forbes There is little empirical evidence on what actually happens when a PHEIC is declared, and said a monkeypox declaration could represent a “test” of the WHO’s post-Covid authority.

tangent

Monkeypox does not spread easily between people and is primarily transmitted through close contact with an infected animal or person, or items such as towels, clothing, or bedding that have been contaminated by someone with an infection. Less commonly, the virus spreads through respiratory droplets produced when you breathe, cough, speak or sneeze, and based on the details of the recent outbreak, experts are investigating the possibility that the virus could be sexually transmitted after being detected in some patients’ semen. While the disease has been spreading for decades in some parts of Africa – where animals are believed to harbor the virus – cases elsewhere are rare and almost always (though not exclusively) linked to travel in the region. Treatments and vaccines for monkeypox are available, although availability is limited and data on their use is scarce.

What we don’t know

While the monkeypox virus is relatively well known, its near-simultaneous emergence in several areas not normally known to be spreading earlier this year alarmed experts and suggests the virus may have been circulating quietly for some time. “Person-to-person transmission is happening and probably underestimated,” Tedros warned. There are many unknowns about how the virus has spread around the world and among whom it is spreading, compounded by testing problems. In Nigeria, Tedros said the proportion of women affected by the disease is “much higher than anywhere else,” although why is not understood. In newly affected countries — such as Europe and North America — cases have been overwhelmingly among men who identify as gay or bisexual, or who have sex with men. This has led to targeted public health measures for vulnerable communities, as well as homophobic backlash, although experts warn that the stigma will make the disease harder to contain and does not reflect the fact that the virus will infect everyone, regardless of sexuality.

Big number

3,200. That’s how many cases of monkeypox have been confirmed and reported to the WHO from 48 countries in the six weeks since the organization was informed of three cases in the UK that had nothing to do with travel, Tedros said at the start of the emergency committee meeting to discuss the outbreak on Thursday. One death was reported in Nigeria. Another 1,500 suspected cases and around 70 deaths have been reported in central Africa this year, Tedros said. This happened mainly in the Democratic Republic of the Congo, but also in the Central African Republic and Cameroon.

Further reading

What you should know about the spread of monkeypox — and whether you should wear a mask (Forbes)

Monkeypox in Africa: the Science the World Ignores (Nature)

WHO calls urgent meeting to clarify whether monkeypox outbreak signals an international emergency (Forbes)

Homophobic misinformation makes curbing the spread of monkeypox more difficult (MIT Tech Review)

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