Outbreak Alerts
Editor: Alyson Browett, MPH

Contributors: Christina Potter, MSPH, Eric Toner, MD, and Rachel Vahey, MHS
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WHO Declares Monkeypox Public Health Emergency of International Concern

The WHO on July 23 declared the ongoing and widespread monkeypox outbreak a Public Health Emergency of International Concern (PHEIC), the agency’s highest level of alert for events that show extraordinary public health risk to other countries through international spread and require coordinated international responses. The designation could prompt more funding for response efforts and enhance coordination and cooperation among the WHO and affected nations, including efforts to more equitably distribute vaccines and treatments that remain in short supply.

In an unusual move, WHO Director-General Dr. Tedros Adhanom Ghebreyesus made the declaration without consensus from the Emergency Committee that met last week, saying there is a “clear risk of further international spread.” The WHO issued a set of Temporary Recommendations for States Parties based on whether they had local transmission, imported cases, no reported cases, or no reported cases in the past 21 days. Additionally, the WHO urged countries with vaccine and therapeutic production capacity to increase and share supplies. 

Though the Emergency Committee does not formally vote, a survey of members showed them split 9-6 in favor of not declaring an emergency. When they convened at the end of June, the split was 11 against and 3 for declaring an emergency. Several members expressed concern that declaring the monkeypox outbreak a PHEIC might provoke stigmatization or discrimination of men who have sex with men (MSM), the community in which the majority of cases are occurring. Dr. Tedros emphasized that any prevention activities should respect the “human rights and dignity” of at-risk populations. 

The US government is considering whether to declare a public health emergency in response to the monkeypox outbreak, although a final decision has not yet been made.