Mpox is Still International Public Health Emergency, WHO Reaffirms

Mpox, formerly known as monkeypox, continues to be classified as an international public health emergency, as affirmed by the World Health Organization (WHO) on February 27, 2025. This decision comes in response to a significant increase in cases and an expanding geographic reach of the virus. The WHO’s emergency committee on mpox convened for the third time on February 25, 2025, and unanimously advised WHO Director-General Tedros Adhanom Ghebreyesus that the situation still warrants the highest level of alert.

The WHO’s statement outlined the reasons for maintaining this designation. The ongoing rise in cases, coupled with the widespread nature of the outbreak, meets the criteria for a public health emergency of international concern (PHEIC). Compounding the issue is the ongoing violence in the eastern Democratic Republic of the Congo (DRC), which severely hampers response efforts. Additionally, insufficient funding poses a significant barrier to implementing effective containment strategies.

Tedros concurred with the committee’s recommendation, extending the PHEIC initially declared on August 14, 2024. A PHEIC represents the most serious level of alarm under the International Health Regulations, which bind 196 countries to respond effectively to public health threats. This classification underscores the urgency of addressing the mpox outbreak, which has seen a notable resurgence since its previous global health emergency status was lifted in May 2023.

The DRC has been at the epicentre of this ongoing epidemic. The WHO had originally declared a public health emergency in July 2022 due to a rapid spread of the disease across Africa, particularly in the DRC. Mpox is caused by a virus closely related to smallpox and can be transmitted through infected animals or via close physical contact between individuals. The disease manifests with symptoms such as fever, muscle aches, and distinctive large boil-like skin lesions. While it is not always fatal, it can lead to severe health complications.

Historically, mpox was first identified in humans in 1970 within the DRC. Since then, it has primarily remained endemic to central Africa. However, in May 2022, clade 2 of the virus gained international attention as it spread globally, disproportionately affecting gay and bisexual men. Since that time, nearly 128,000 mpox cases have been confirmed across 130 countries, resulting in 281 fatalities according to WHO data.

Despite initial success with vaccination campaigns and awareness initiatives that curtailed the outbreak’s spread, a new two-pronged epidemic emerged in early 2024. This resurgence involved both clade 1a and a newly identified strain, clade 1b. The WHO’s decision to declare an emergency in August 2024 was driven by these developments. Reports indicate that community transmission of clade 1b has been confirmed not only in the DRC but also in five other African nations. Furthermore, this strain has been detected in an additional 15 countries globally, often linked to international travel.

Last year alone, the DRC reported over 13,000 mpox cases and 43 deaths. Alarmingly, in just the first five weeks of this year, more than 2,000 new cases were confirmed in the DRC—accounting for over half of all reported cases worldwide during that period. This troubling trend highlights the urgency for international collaboration and resource allocation to combat this health crisis.

As health authorities continue to grapple with the challenges posed by mpox, it becomes increasingly critical to foster a comprehensive response that addresses both prevention and treatment strategies. Public health messaging around vaccination and safe practices is paramount to mitigate further spread. The global community must remain vigilant and proactive in its approach to managing this infectious disease.

The WHO’s commitment to monitoring and responding to mpox reflects a broader understanding of infectious diseases’ potential impact on global health security. While progress has been made since the initial outbreak was declared a public health emergency, ongoing challenges underscore the complexities of managing zoonotic diseases—those transmitted from animals to humans.

In light of these developments, healthcare systems worldwide must prepare for potential scenarios that could arise should mpox continue its spread. Surveillance measures need enhancement alongside educational campaigns targeting at-risk populations to ensure informed decisions can be made regarding personal health.

Maintaining an open dialogue among nations is essential in sharing data and resources effectively. The interconnectedness of our world means that disease outbreaks do not respect borders; therefore, collective action is crucial.

Mpox remains a significant concern for global public health as it continues to evolve. The WHO’s recent declaration serves as a reminder of the persistent threat posed by infectious diseases and the necessity for sustained vigilance and collaborative efforts. Ensuring robust health infrastructures and public awareness will be vital as we navigate this ongoing challenge.

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