The World Health Organization (WHO) has officially declared the ongoing monkeypox outbreak a “Public Health Emergency of International Concern” (PHEIC) following a surge in cases across Africa.

The decision comes in response to escalating numbers of infections, particularly in the Democratic Republic of Congo (DRC), which accounts for over 90% of reported cases since the beginning of 2024.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus announced the decision on social media, stating, “The global community must act swiftly to prevent further transmission, treat those infected, and save lives.” The declaration marks the highest level of international alarm, compelling countries to enhance coordination and response efforts.

Monkeypox, formerly known as monkeypox, has spread rapidly across at least 13 African nations, including Burundi, Kenya, Rwanda, and Uganda. So far this year, there have been 2,863 confirmed cases and 517 deaths, with suspected cases exceeding 17,000 across the continent.

The virus, primarily transmitted through close contact, presents with symptoms including rashes, fever, and swollen lymph nodes, and can be fatal in vulnerable populations.

Dr. Tedros emphasized the need for immediate global funding to combat the outbreak, stating that WHO has released $1.45 million from its Contingency Fund for Emergencies, with an appeal to donors for an additional $15 million to support surveillance, testing, and treatment efforts.

Africa CDC Takes Action

On the same day, the Africa Centres for Disease Control and Prevention (Africa CDC) declared monkeypox a “Public Health Emergency of Continental Security” (PHECS), marking a significant escalation in the continent’s response. This declaration enables the mobilization of resources and the coordination of efforts across affected countries to halt the virus’s spread.

Africa CDC Director General Dr. Jean Kaseya stressed the urgency of the situation, calling for “swift and decisive action” to bolster health systems, surveillance, and laboratory capacities. He appealed to international partners for support, urging a more proactive approach than seen during the initial monkeypox outbreak in 2022, which largely overlooked Africa as global cases declined.

To bolster the response, Africa CDC has established a 25-member Incident Management Team and forged partnerships to distribute over 215,000 doses of the MVA-BN® vaccine, the only FDA and EMA-approved monkeypox vaccine, across affected countries.

This partnership includes the European Commission’s Health Emergency Preparedness and Response Authority (HERA) and vaccine manufacturer Bavarian Nordic. Africa CDC will oversee the equitable distribution of these vaccines to prioritize the most affected regions.

Rising Concerns Over HIV and Monkeypox Co-Infection

Health experts are particularly concerned about the rising number of fatalities, with some suspecting a link between monkeypox and HIV. Professor Salim Abdool Karim, chair of Africa CDC’s Emergency Consultative Group, warned that individuals living with HIV may be more susceptible to severe monkeypox infections, contributing to the higher mortality rates observed in Africa. This has prompted calls for increased attention to the intersection of these two epidemics.

Additionally, the emergence of a new strain of the virus, Clade 1b, has complicated containment efforts. This strain, which is spreading primarily through sexual networks in the DRC and neighboring countries, has added a new layer of urgency to the response.

With limited diagnostic capabilities and insufficient vaccine supplies, health authorities are struggling to keep pace with the virus’s rapid spread.

Global Response and Resource Allocation

The monkeypox outbreak has drawn significant attention from both international organizations and governments worldwide. The declaration of the outbreak as a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) has set into motion a broad global response.

This emergency status is the highest level of international alarm under the International Health Regulations (IHR), which obliges member states to cooperate and share resources in the fight against infectious diseases.

One of the key challenges identified in this outbreak has been the lack of sufficient diagnostic and healthcare infrastructure across many African countries.

The WHO’s response has included not only funding but also technical support to bolster local health systems. The $15 million response plan, for which WHO has already released $1.45 million from its Contingency Fund for Emergencies, is designed to address the critical needs of affected countries.

This includes ramping up testing capabilities, improving case management, strengthening epidemiological surveillance, and ensuring that healthcare workers have adequate protective gear and resources. WHO is also working to facilitate vaccine access for countries that do not have the means to procure them independently.

The Emergency Use Listing process, which WHO has initiated for monkeypox vaccines, aims to accelerate vaccine approval and distribution, particularly in lower-income countries. This will be essential for controlling the outbreak and preventing further spread beyond Africa.

Symptoms and Prevention

Monkeypox symptoms typically include skin rashes, fever, headaches, muscle aches, and swollen lymph nodes. Transmission occurs through close contact with an infected person, contaminated objects, or animals. Public health experts recommend vaccination, improved hygiene practices, and social distancing measures to curb the spread of the virus.

Both WHO and Africa CDC are advocating for expanded vaccination campaigns, increased surveillance, and enhanced laboratory testing to bring the outbreak under control. As the world watches, the hope is that swift action will prevent the spread of the virus beyond Africa and mitigate the human toll.

Vaccine Access and Distribution

One of the most significant developments in the response to the monkeypox outbreak has been the coordination between the Africa CDC and international partners like the European Commission and vaccine manufacturers.

The MVA-BN® vaccine, which is the only vaccine currently approved by both the FDA (U.S. Food and Drug Administration) and EMA (European Medicines Agency) for use against monkeypox, is central to vaccination efforts. However, supplies are limited.

Africa CDC’s role in distributing these vaccines equitably across affected regions is critical. The 215,000 doses being provided through partnerships with HERA and Bavarian Nordic represent a significant step forward, but these numbers still fall short of what is needed to fully control the outbreak.

To address this gap, Africa CDC is prioritizing the most affected and at-risk regions for vaccine distribution while also working to scale up vaccination campaigns.

Outlook for the Future

The monkeypox outbreak in Africa underscores the broader vulnerabilities within global health systems when it comes to managing infectious diseases. The current situation offers a stark reminder that diseases endemic to certain regions can rapidly become global threats without adequate preparedness and response.

As health authorities continue to tackle the outbreak, there is hope that the lessons learned will lead to more resilient healthcare systems in Africa and a more equitable approach to managing global health emergencies in the future.

For now, the focus remains on halting the spread of monkeypox through coordinated efforts involving surveillance, vaccination, public health campaigns, and international cooperation.

The WHO and Africa CDC’s actions are an urgent call to mobilize resources and expertise to contain the outbreak before it escalates into a broader global crisis.

With vaccines being deployed, funding being raised, and a more focused international response underway, there is optimism that the tide can be turned in the fight against monkeypox.

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