LONDON — The World Health Organization said the expanding monkeypox outbreak in more than 70 countries is an “extraordinary” situation that now qualifies as a global emergency, a declaration Saturday that could spur further investment in treating the once-rare disease and worsen the scramble for scarce vaccines.
WHO Director-General Tedros Adhanom Ghebreyesus made the decision to issue the declaration despite a lack of consensus among members of WHO’s emergency committee. This is the first time that the U.N.’s chief health officer has made such an act.
“In short, we have an outbreak that has spread around the world rapidly through new modes of transmission about which we understand too little and which meets the criteria in the international health regulations,” Tedros said.
“I know this has not been an easy or straightforward process and that there are divergent views among the members” of the committee, he added.
While monkeypox was a common disease in West Africa, there were no known outbreaks. It has also been present in some parts of Central and West Africa for over ten years. Authorities discovered that it could spread rapidly among the population until May.
Declaring a global emergency means the monkeypox outbreak is an “extraordinary event” that could spill over into more countries and requires a coordinated global response. WHO has previously declared an emergency for public health emergencies such as the COVID-19 pandemic and 2014 West African Ebola epidemic.
The declaration of emergency serves mainly to appeal to more international resources and attention for an outbreak. Previous announcements were not as effective because the U.N. Health Agency is often powerless to convince countries to respond.
Last month, WHO’s expert committee said the worldwide monkeypox outbreak did not yet amount to an international emergency, but the panel convened this week to reevaluate the situation.
The U.S. Centers for Disease Control and Prevention reports that more than 16,000 monkeypox cases have been recorded in 74 countries, since May. Monkeypox has been fatally reported only in Africa to date. This is where the more serious version of monkeypox virus is being spread, mostly in Nigeria and Congo.
The monkeypox virus is spread mainly to Africans from the infected rodents and wild animals. There are very few cases that have crossed national borders. However, monkeypox has been spreading to North America, Europe and the rest of the globe. It is not spread to anyone with any links to Africa or recently returned from Africa.
WHO’s top monkeypox expert, Dr. Rosamund Lewis, said this week that 99% of all the monkeypox cases beyond Africa were in men and that of those, 98% involved men who have sex with men. Experts think the monkeypox epidemics in North America and Europe were caused by sex at raves held in Spain and Belgium.
Michael Head, a senior research fellow in global health at Southampton University, said it was surprising WHO hadn’t already declared monkeypox a global emergency, explaining that the conditions were arguably met weeks ago.
Some experts have questioned whether such a declaration would help, arguing the disease isn’t severe enough to warrant the attention and that rich countries battling monkeypox already have the funds to do so; most people recover without needing medical attention, although the lesions may be painful.
“I think it would be better to be proactive and overreact to the problem instead of waiting to react when it’s too late,” Head said. He added that WHO’s emergency declaration could help donors like the World Bank make funds available to stop the outbreaks both in the West and in Africa, where animals are the likely natural reservoir of monkeypox.
Experts in the U.S. speculate that monkeypox could be on the brink of being an established sexually transmitted disease, similar to gonorrhea and herpes.
“The bottom line is we’ve seen a shift in the epidemiology of monkeypox where there’s now widespread, unexpected transmission,” said Dr. Albert Ko, a professor of public health and epidemiology at Yale University. “There are some genetic mutations in the virus that suggest why that may be happening, but we do need a globally-coordinated response to get it under control,” he said.
Ko demanded that testing be scaled rapidly and immediately, pointing out that, similar to COVID-19’s early days, there are significant gaps in surveillance.
“The cases we are seeing are just the tip of the iceberg,” he said. “The window has probably closed for us to quickly stop the outbreaks in Europe and the U.S., but it’s not too late to stop monkeypox from causing huge damage to poorer countries without the resources to handle it.”
Some experts in America have suggested that monkeypox may be the new sexually transmitted illness. The officials estimate that about 1.5 million American men could become infected.
Dr. Placide Mbala, a virologist who directs the global health department at Congo’s Institute of National Biomedical Research, said he hoped any global efforts to stop monkeypox would be equitable. However, despite the fact that many countries, including Britain, Canada and Germany, have placed orders for millions of vaccines, no one has sent any to Africa.
“The solution needs to be global,” Mbala said, adding that any vaccines sent to Africa would be used to target those at highest risk, like hunters in rural areas.
“Vaccination in the West might help stop the outbreak there, but there will still be cases in Africa,” he said. “Unless the problem is solved here, the risk to the rest of the world will remain.”
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