The resurgence of mpox, especially due to the monkeypox virus (MPXV) clade Ib, continues to challenge global health systems. On November 22, 2024, the World Health Organization (WHO) convened its second International Health Regulations (IHR) Emergency Committee meeting to assess the public health emergency of international concern (PHEIC) status declared earlier in August. This meeting, held virtually, brought together 13 members and one advisor to deliberate on the evolving crisis and suggest refined recommendations for its containment.
The Current Global Landscape
Mpox cases have been reported across all six WHO regions, with the African Region facing the most severe impact due to clades Ia, Ib, and IIa. The Democratic Republic of Congo (DRC) remains the epicenter, with MPXV clade Ib spreading to six provinces, including Kinshasa. Neighboring countries such as Burundi, Uganda, Kenya, and Rwanda have also reported clusters of cases, with sustained community transmission observed in some areas.
Other regions, including the Americas, Europe, and Southeast Asia, have also reported travel-linked cases. Alarmingly, children and younger populations are increasingly affected, indicating shifting transmission dynamics within households and broader communities.
Challenges in the Response
Despite efforts to curb the spread of mpox, several obstacles persist:
Operational Gaps: Limited testing, delayed case isolation, and incomplete contact follow-ups hinder containment.
Vaccine Implementation: Challenges include regulatory delays, hesitancy, and low coverage in targeted groups. The effectiveness of post-exposure vaccination also remains uncertain.
Concurrent Health Crises: Competing priorities and limited resources in affected countries exacerbate the situation.
WHO Deputy Director-General emphasized the need for political commitment and scaled-up interventions. The collaboration between WHO and Africa CDC has been instrumental in establishing frameworks like the Mpox Continental Preparedness and Response Plan and the Access and Allocation Mechanism (AAM) to ensure equitable distribution of vaccines, therapeutics, and diagnostics.
Deliberations and Recommendations
In the open session, representatives from affected countries shared updates on their situations and response strategies. While vaccination efforts are underway in the DRC and Rwanda, countries like Kenya and Uganda are still in the planning phase. Burundi has opted not to incorporate vaccination into its current strategy.
The committee discussed refining risk assessments, leveraging mathematical modeling for spread predictions, and integrating localized vaccination efforts with broader public health strategies. They also emphasized the importance of addressing vaccine hesitancy and enhancing surveillance and data collection.
Moving Forward
The committee reaffirmed that the mpox upsurge continues to meet the criteria for a PHEIC, urging intensified global and national efforts. Recommendations included:
- Strengthening local and international coordination to scale up integrated responses.
- Expanding access to vaccines and diagnostics, especially in high-risk regions.
- Enhancing public awareness to combat stigma and promote vaccination.
The meeting underscored the importance of collective action and resource mobilization to tackle this multifaceted crisis. The WHO’s strategic plans and partnerships with regional organizations remain pivotal in mitigating the impact of mpox globally.
By fostering collaboration and addressing the identified gaps, the international community can work towards containing mpox and preventing future outbreaks.
