WHO declares monkeypox an international health emergency

The designation does not oblige countries to take new measures to manage the virus, but it does sound the alarm to deal with the threat of epidemics – even if Covid-19 and poliomyelitis remain active international public health emergencies. .

“The WHO assessment is that the risk of monkeypox is moderate globally, except in the European region, where we assess the risk to be high,” said WHO Director-General Tedros Adhanom. Ghebreyesus, in his announcement. “With the tools we have now, we can stop transmission and bring this outbreak under control.”

The WHO called a meeting a month ago to determine whether monkeypox was a USPPI, but then decided it was not despite some advisers disagreeing with the call. At that time, there were about 3,300 cases worldwide, including 150 in the United States.

Now there are more than 16,800 reported cases worldwide, including nearly 2,900 in the United States

Yet many questions remain unanswered, including why so many new infections are being reported in countries where the virus is not endemic. These cases have already led to increased demand for vaccines and therapeutics that could be used to stop the spread and treat those already infected.

The WHO’s decision comes despite its emergency committee not being able to reach consensus on whether the virus constitutes an international health emergency. But the declaration brings a new international emergency on top of already rushed efforts to secure supplies to treat the cases.

“We’re in a sort of paradoxical situation with monkeypox,” Piero Olliaro, a University of Oxford researcher who has advised WHO members on monkeypox research priorities, told POLITICO on Wednesday. “On the one hand, our knowledge of the clinical presentation and outcome of monkeypox in the Western world is improving, and we even potentially have one or more treatments and a vaccine, on the other hand, we still have little evidence for support which intervention should be used and how to break chains of transmission and how to manage cases effectively.

In search of vaccines and therapies

Also unlike Covid-19, vaccines and treatments that can be used for monkeypox already exist – although many are approved for smallpox and face regulatory hurdles for full approval.

Jynneos, a third-generation smallpox vaccine that has also been approved for monkeypox in some countries, has so far been considered the best choice for managing outbreaks, although relatively few doses are available worldwide. The United States has shipped more than 300,000 doses of the vaccine, and millions more are on the way — to help fill shortages in states and cities. And countries have followed suit, with European countries ordering more than a million doses earlier this month.

In its initial guidelines, the WHO included two other vaccine options for potential use in patients with monkeypox. Another third-generation vaccine is currently only held in Japan, although the WHO is discussing with the country to expand access, Rosamund Lewis, technical lead for monkeypox at WHO, told POLITICO in an interview. former.

The third vaccine in the list – ACAM2000 – is available in much larger quantities. The United States has about 100 million doses of the second-generation vaccine in stock, although it has not been officially approved in the United States for monkeypox except as an investigational new drug.

And the rush for resources extends beyond vaccines to antivirals. Tecovirimat, a promising orthopox antiviral for the treatment of monkeypox, is relatively rare worldwide. Siga, the small company that makes Tecovirimat, is talking to dozens of countries about ordering the drug – and is looking to expand its manufacturing capacity.

Beyond the statement

Declaring monkeypox a public health emergency of international concern is unlikely to change what countries are doing to control the virus. Orders for vaccines and therapeutics, as well as expanded testing and public messaging, will continue.

Ahead of Saturday’s announcement, U.S. officials were discussing how to elevate their own response, including declaring a national public health emergency and looking for ways to better distribute limited doses across a broad population.

Global health equity has been a critique of early responses to monkeypox – as it has been during the pandemic – with few endemic countries having access to the now more widely used countermeasures.


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