The World Health Organization (WHO) has declared the surge in mpox cases in several African countries a global public health emergency, as the lack of accessibility to vaccines and treatments heavily influences the virus’s impact.

Earlier this week, the Africa Centres of Disease Control and Prevention declared its own public health emergency in regards to mpox outbreaks that caused over 500 deaths in 13 countries in the continent. According to their data, 96% of all cases and deaths are in the Democratic Republic of Congo.

The outbreak in Congo started with the spread of an endemic strain, called clade 1. However, a new version of mpox with a higher death rate, known as clade 1b, appears to be spreading in the country. “We are now in a situation where (mpox) poses a risk to many more neighbours in and around central Africa,” said South African infectious diseases expert Salim Abdool Karim, who is the chair of the Africa Centres of Disease Control emergency group.

Officials at the Centre stated that 70% of cases detected in the Democratic Republic of Congo are in children younger than 15, who also account for 85% of the deaths. The virus has spread to Congo’s neighbouring countries, including Burundi, Kenya, Rwanda and Uganda, where vaccines and treatments are in low supply.

Today, we declare #Mpox a Public Health Emergency of Continental Security.
With 2,863 confirmed cases and 517 deaths across 13 African countries in 2024 alone, Mpox is a crisis demanding our collective action. @AfricaCDC is activating resources, partnerships, and leading… pic.twitter.com/RQr46zhjxq

— Africa CDC (@AfricaCDC) August 14, 2024

The declaration of emergency from the Africa Centres of Disease Control triggered action from WHO, with Director-General Dr Tedros Adhanom Ghebreyesus determining that these new outbreaks constitute a “public health emergency of international concern”, also known as PHEIC. This is WHO’s highest level of alert, which can accelerate research and mobilise funding, in addition to triggering emergency responses in countries worldwide.

Dr Tedros noted that more than 14,000 cases and 524 deaths have been reported this year in the Democratic Republic of Congo (DRC), already exceeding last year’s total. “The detection and rapid spread of a new clade of mpox in eastern DRC, its detection in neighbouring countries that had not previously reported mpox, and the potential for further spread within Africa and beyond is very worrying,” Dr Tedros said.

“We are not dealing with one outbreak of one clade: we are dealing with several outbreaks of different clades in different countries with different modes of transmission and different levels of risk,” Dr Tedros added.

In its response plan, WHO has already released $1.5 million in contingency funds and is going to appeal to donors for additional funding.

This is the second time that WHO has declared mpox to be a global public health emergency. In May 2022, mpox cases surged worldwide, even in countries were the virus was not endemic, and the virus mostly affected gay, bisexual and other men who have sex with men. The 2022/23 outbreak was due to mpox clade 2b, a different strain to the current outbreak in central Africa.

In Ireland, MPOWER was a member of the mpox national crisis management team led by the HSE. The mpox outbreak was successfully controlled thanks in part to risk communication and community engagement led by the MPOWER team. Moreover, in European countries, vaccines and treatments were made readily available in comparison to the situation in several African nations.

During and since the last mpox PHEIC in 2022, diagnostics, vaccines and treatment were not available in the global South.

It’s critical that Europe and the US hear this call from African nations and step up. There’s no need to repeat mistakes of the past. https://t.co/4feDsd1ZPe

— Adam Shanley (@Adlers1) August 14, 2024

Speaking about the surge in mpox cases and the declaration of global public emergency, MPOWER Programme Manager Adam Shanley said: “It’s important to know that during and since the last mpox outbreak in 2022/23, no vaccines or treatment were made available in Africa.

“This kind of blatant health inequity must stop. When we have effective vaccines to prevent mpox and antivirals to treat mpox, they must be made available to those that can benefit from them the most, regardless of what part of the world that may be or how wealthy their nations are,” Shanley added.

“The increase in clade 1b in the Democratic Republic of Congo has been recognised for some time now and is being monitored in Ireland and internationally,” he further explained. “It is possible, due to our interconnected world, that international spread may occur.

“However, no cases of clade 1 have been identified in Ireland (or Europe) yet. Sporadic cases of mpox do still occur in Ireland. These cases are investigated and shown to be 2b.

“MPOWER continues to engage with colleagues in the HSE and across Europe on mpox. Should any new information or developments occur that may affect Ireland, the MPOWER team will be ready to get that information to the community.”