IHR Emergency Committee stops short of declaring the monkeypox epidemic a global emergency

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Two days after the International Health Regulations (IHR) Emergency Committee deliberated on the current multi-country monkeypox outbreak, the World Health Organization (WHO) issued a statement on June 25, 2022. They wrote on the Committee’s advice that the monkeypox epidemic does not constitute a Public Health Emergency of International Concern (PHEIC).

Logo of the World Health Organization

After the meeting, WHO Director-General Dr. Tedros Adhanom Ghebreyesus issued his own carefully crafted contributory remarks, writing, “I am deeply concerned by the spread of monkeypox, which has now been identified in more than 50 countries, across five WHO regions, with 3,000 cases since early May. The Emergency Committee shared serious concerns about the scale and speed of the current outbreak, noted many unknowns, gaps in current data, and prepared a consensus report that reflects differing views among the Committee.”

Under the IHR provisions, a PHEIC is “an extraordinary event, which constitutes a public health risk to other states through international transmission, and which potentially requires a coordinated international response.” Under such a declaration, countries have a legal obligation to respond promptly to the threat posed by the infectious pathogen or, for that matter, chemical agents and radioactive material that threaten populations of multiple geographic regions.

Since the first case of monkeypox was confirmed on May 6, 2022, in a British citizen flying back from Nigeria, the number of confirmed and suspected cases has climbed to 4,229, according to Our World in Data. The seven-day rolling average of new cases has been steadily rising; the latest figure is around 230 cases per day.

In all, 66 countries and territories have detected monkeypox infections. In Europe, Germany, Britain, Spain, France and Portugal are the epicenters of the monkeypox outbreak, and the US and Canada have each reported more than 200 monkeypox cases.

The Emergency Committee was briefed on the current assessment, including concerns raised on the lack of any epidemiological links to areas, mainly in west and central Africa, that are endemic for monkeypox, underscoring the undetected transmission that may have been proceeding for some time in the more impacted countries.

Under the present circumstances, why then didn’t the IHR Emergency Committee declare a PHEIC?

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