WHO declares mpox outbreaks in Africa a global health emergency as new form of virus spreads

The World Health Organization has declared the monkeypox outbreak in the Democratic Republic of Congo (DRC) and other parts of Africa a global emergency. Currently, over a dozen countries have confirmed cases of infection in children and adults, and a new form of virus transmission has emerged. The extremely limited vaccine doses available on the African continent are making the situation even more critical.

WHO Director-General Tedros Adhanom Ghebreyesus stated on Wednesday (early Thursday Australian Eastern Time) that "This should be a cause for concern for all of us... the possibility of the outbreak further spreading outside of Africa is deeply worrying." The Africa Centres for Disease Control and Prevention (Africa CDC) had previously stated that monkeypox has been detected in 13 countries this year, with over 96% of cases and deaths occurring in the DRC.

Compared to the same period last year, the number of cases has increased by 160%, and the number of deaths has risen by 19%. To date, over 14,000 cases and 524 deaths have been reported. Salim Abdool Karim, chair of the Africa CDC's emergency team and a South African infectious disease expert, noted that, "What we are now facing is that monkeypox is posing a risk to more neighboring countries in Central Africa and around it." He also mentioned that the new version of the monkeypox virus spreading from the DRC has a mortality rate of about 3-4%.

In the global monkeypox outbreak that affected over 70 countries in 2022, the death rate was less than 1%. Michael Marks, a professor of medicine at the London School of Hygiene and Tropical Medicine, stated that if declaring the African monkeypox outbreak an emergency can bring more support to control the epidemic, then it is necessary. "The global community has failed to provide the necessary resources in a timely manner, leading to such a bad situation; this is a failure," he said.

Officials at the Africa CDC stated that nearly 70% of cases in the DRC are among children under the age of 15, who also account for 85% of the deaths. Jacques Alonda, an epidemiologist working in the DRC with international charities, said that he and other experts are particularly concerned about the spread of monkeypox in the conflict-ridden eastern refugee camps of the DRC. "The worst case I've seen is a six-week-old baby who contracted monkeypox when he was two weeks old," Alonda said, adding that the baby has been under their care for a month. "He was infected because the hospital was overcrowded, forcing him and his mother to share a room with another person with an undiagnosed viral infection."

Save the Children stated that the health system in the DRC is already "collapsing" under the pressure of malnutrition, measles, and cholera. Tedros said that officials are facing monkeypox outbreaks in multiple countries, with "different modes of transmission and different levels of risk." The UN health agency said that monkeypox has recently been detected for the first time in four East African countries (Burundi, Kenya, Rwanda, and Uganda). All these outbreaks are related to the outbreak in the DRC. In Côte d'Ivoire and South Africa, health authorities have reported another less dangerous monkeypox outbreak, which spread globally in 2022.

Earlier this year, scientists reported a more deadly monkeypox virus in a mining town in the DRC, with a mortality rate of up to 10%, and they are concerned that this virus may be easier to transmit. Monkeypox is mainly spread through close contact with infected people, including sexual contact. Unlike previous monkeypox outbreaks, where lesions mainly appeared on the chest, hands, and feet, the new form of monkeypox has milder symptoms, with lesions appearing on the genitals. This makes it harder to detect, meaning people may unknowingly infect others.

In 2022, the WHO declared monkeypox a global emergency after it spread to more than 70 countries that had not previously reported the disease, mainly affecting gay and bisexual men. Before this outbreak, the disease mainly occurred sporadically in Central and West Africa when people had close contact with infected wild animals. Western countries have mainly used vaccines and treatments to stop the spread of monkeypox, but Africa has few of these resources.

Marks from the London School of Hygiene and Tropical Medicine said that in the absence of Western-licensed monkeypox vaccines, officials could consider vaccinating people with smallpox vaccines, a related disease. "We need a large supply of vaccines so that we can vaccinate the most vulnerable people," he said, adding that this would mean sex workers, children, and adults living in areas where the outbreak is occurring. Congolese authorities said they have requested 4 million doses of monkeypox vaccine, according to Chris Kasita Osako, coordinator of the DRC's monkeypox response committee, who told the Associated Press. Osako said the vaccines are primarily for children under the age of 18.

"The United States and Japan are two countries that have indicated their willingness to provide us with vaccines," Osako said. Although the WHO's emergency declaration is intended to prompt donor agencies and countries to take action, the global response to previous emergency declarations has been mixed. Dr. Boghuma Titanji, an infectious disease expert at Emory University, said that the last WHO emergency declaration on monkeypox "did little to get supplies such as diagnostic tests, drugs and vaccines into Africa." "The world now has a real opportunity to act decisively and not repeat the same mistakes, but that requires more than just a (emergency) declaration," Titanji said.