Understand why mpox has been declared a global public health emergency

Why did the WHO declare a Public Health Emergency?

Declaring a Public Health Emergency of International Concern (PHEIC) is the highest level of alert by the World Health Organization (WHO). It's intended to send a powerful signal to countries to initiate urgent action to combat the spread of a disease and to mobilise resources to fund research on diagnostics, treatments and vaccines. This status also obligates countries to share information with the WHO, so allowing for monitoring of the spread of infections globally. In other words, PHEIC status raises awareness, triggers action, and ensures notifiable reporting of cases. The rise in cases and deaths, particularly among children, is linked to the discontinuation of the smallpox vaccine (which provides protection against mpox) and high malnutrition rates in affected regions.

• Read the WHO Director-General's 14 August 2024 statement

The WHO's declaration of a PHEIC follows an increase in the number of cases of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa. As of 14 August 2024, there were 15 600 recorded cases and 537 deaths.

• Mpox, formerly known as monkeypox, isn't a new disease. The virus that causes the disease was discovered in captive monkeys in 1958. The first human case of monkeypox was recorded in 1970. Monkeypox has affected people in central and west Africa for decades. It's been controlled through simple measures like isolating infected people.
• In November 2022, the WHO indicated that the new preferred term for monkeypox was 'mpox'. This is because the use of racist and stigmatising language increased after an outbreak of monkeypox earlier in 2022.
• Seven events have been declared a PHEIC between 2007 and 2022. These were the 2009 H1N1 influenza pandemic; Ebola (West African outbreak 2013-2015, outbreak in Democratic Republic of Congo 2018-2020); Poliomyelitis (2014 to present); Zika (2016); COVID-19 (2020); Monkeypox (2022).

New strain of mpox spreads rapidly

The reason for the declaration of a PHEIC in the case of mpox is the alarming rapid spread, particularly of the new strain of mpox, clade 1b, which emerged in the DRC in 2023. According to the WHO, clade 1b is spreading mainly through sexual networks and has been detected for the first time in countries neighbouring the DRC. The concern in Africa is the continent's lack of treatments and vaccines.

• Until May 2022, mpox hadn't caused any sizeable outbreaks beyond African countries where mpox is endemic (meaning it's long been present in an area or population).
• In July 2022, the WHO announced a PHEIC as the disease spread across several African countries, Europe and the Americas, with 100 countries reporting around 87 000 cases and 112 deaths.
• The PHEIC was declared over in May 2023 after there had been a sustained decline in global cases.
• According to South Africa's National Institute for Communicable Diseases (NICD), the outbreak has affected 13 African countries since 1 January 2024. As of 28 August 2024, 18 737 cases (3 101 confirmed, 16 636 suspected) and 541 deaths of mpox have been recorded in Burundi, Cameroon, Central Africa Republic (CAR), Congo, Cote d' Ivoire, DRC, Ghana, Kenya, Liberia, Nigeria, Rwanda, South Africa, and Uganda. This number might be higher as not all cases of illness had been tested for the disease.

Let's look at the case load in South Africa

In South Africa, the National Department of Health announced that the total number of positive mpox cases recorded as of 18 August 2024, was 24. Nineteen of these cases had recovered, three had died, and two active cases were isolating at home. Twelve of these cases were reported in Gauteng, 11 in KwaZulu-Natal and one in the Western Cape. The NICD has published a dashboard which contains live updates on mpox in South Africa. South Africa is currently experiencing an outbreak of mpox clade 2 and has not detected any cases of mpox clade 1.

Find out more

Read our related articles for more information:

• 15 simple monkeypox facts to keep in mind - Discovery
• How it spreads, symptoms, prevention and more - Discovery

Get the facts from reliable sources

For the most accurate and up-to-date information, consult the National Institute for Communicable Diseases (NICD) in South Africa and the World Health Organization.