World Health Organization (WHO). declared the current monkeypox epidemic is a global public health emergency.

A committee of independent advisers, which met on Thursday 21 July 2022, did not share its decision on whether to designate the growing outbreak of monkeypox as a Public Health Emergency of International Concern (PHEIC) – the highest level of risk.

The head of the WHO, Dr. Tedros Adhanom Ghebreyesus, broke the deadlock and declared an outbreak of PHEIC. This is the first time that the Director General of WHO stepped aside from his advisers declare a public health emergency.

The first case of monkeypox was reported in a child in the Democratic Republic of the Congo (then Zaire) in 1970. Since then, outbreaks have usually been small and traced to people who had recently returned from a country where the virus is endemic – that is, countries in West and Central Africa . But the current outbreak differs from any previous outbreak outside of Africa in that there is sustained human-to-human transmission.

As of July 22, there were 16,593 confirmed infections in 68 countries which historically did not report monkeypox. Most of the infections are reported from Europe. The vast majority of infections occur in men who have sex with men, especially men who have sex with multiple partners.

Models provided by the WHO show that the average number of people infected per infected person (called zero R – remember that from the early days of the COVID pandemic?) is between 1.4 and 1.8 in of men who have sex with men, but less than 1.0 in other populations. Therefore, although occasional infections may spread to populations other than men who have sex with men, further significant spread is unlikely.

In Europe, in recent weeks, a slowing growth new cases of monkeypox every week. The vast majority of infections still occur in men who have sex with men.

In the UK, 97% of cases are among men who have sex with men, but the rate of the epidemic appears to have dropped to zero. even turned negative in recent weeks. But it is plausible that the apparent drop in new infections is a gap between successive waves.

Recently, experts have been debating whether it should monkeypox is now a venereal disease. Although monkeypox is undoubtedly spread during sex, labeling it an STD would be counterproductive, as the infection can be spread through any intimate contact, even with the use of condoms or without penetrative sex.

Cumulation of confirmed cases of monkeypox during the current outbreak.
Our world is in data, CC BY

Pros and cons of declaring a global health emergency

In general, the WHO Emergency Committee’s arguments in favor of declaring a global health emergency included that monkeypox satisfied requirement of PHEIC according to the WHO’s International Health Regulations: “an emergency event that poses a health risk to other States through international transmission and that potentially requires a coordinated international response.”

Added to this is the concern that in some countries there is the possibility of significant underreporting of cases, periodic reports of infections in children and pregnant women, concerns that infections may become endemic in human populations or be reintroduced into at-risk populations even after the current monkeypox pandemic is over.

Arguments against declaring a global health emergency included the fact that the vast majority of infections are currently only in 12 countries in Europe and North America, and there is evidence that cases are stabilizing or even falling in those countries.

Almost all cases are in men who have sex with men and have multiple partners, making it possible to stop transmission with interventions aimed at this group. Another argument – the severity of the disease on the street seems small.

Although the emergency committee could not reach a consensus, Tedros took the decision to declare a PHEIC.

This declaration of a global health emergency is unlikely to lead to major changes in control activities in the worst-affected countries outside of Africa. However, it could encourage those countries that have so far seen few cases to make sure their health systems are better able to deal with the spread of the infection in their countries. Hopefully, it can also stimulate funding for research and improve the ability of endemic countries to fight the disease.

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