Monkeypox declared a global public health emergency on 23 July: What does this mean?

Why has the WHO declared a Public Health Emergency (PHEIC)?

Declaring a PHEIC is the highest level of alert by the WHO. It's intended to send a powerful signal to countries to initiate urgent action to combat the spread of the disease and to mobilise resources to fund research on diagnostics, treatments and vaccines. It also obligates countries to share information with the WHO, to monitor the spread of infections globally. In other words, this PHEIC status raises awareness, triggers action, and ensures notifiable reporting of cases.

This WHO's declaration of a PHEIC follows a change in the pattern of Monkeypox spread, in line with the recent rapid spread of monkeypox across all continents. There are now about 16,000 recorded cases across more than 75 countries. The disease appears to be spreading in countries that have not historically reported monkeypox infections and through new modes of transmission, which are not yet fully understood.

Fortunately, Monkeypox is almost never fatal, and typically resolves spontaneously. Of all the cases recorded in the recent outbreak, there are only 5 confirmed deaths.

• Examples of other PHEICs: Six events were declared a PHEIC between 2007 and 2022: The 2009 H1N1 influenza pandemic; Ebola (West African outbreak 2013-2015, outbreak in Democratic Republic of Congo 2018-2020); Poliomyelitis (2014 to present); Zika (2016); COVID-19 (2020).

"Risk of monkeypox is moderate globally and in all regions, except in the European region"

Until May 2022 monkeypox hadn't caused any sizeable outbreaks beyond the African countries where monkeypox is endemic. When a disease is "endemic" this means it's long been present in an area or population.

There are suspicions that super spreader events in Europe, attended by one or more infected people, might be behind the recent increase in cases.

WHO's assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where the WHO assesses the risk as high. At present, the highest cases numbers are being recorded in the United States of America and Europe. There is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment.

Let's look at the case load in South Africa

• In summary, in South Africa only three cases of monkeypox (not linked to each other) have been formally confirmed in this outbreak (from 22 June to date of publication). These cases have been appropriately isolated, and their contacts traced to limit the spread of infection. To the best of our understanding, all three patients have experienced mild illness.
• At the time of publication, no Discovery Health Medical Scheme (DHMS) members had tested positive for monkeypox.

"Stigma and discrimination can be as dangerous as any virus"

In addressing the media WHO Director General Tedros Adhanom Ghebreyesus emphasised that, "Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners."

He added: "Stigma and discrimination can be as dangerous as any virus. I am calling on civil society organizations, including those with experience in working with people living with HIV, to work with us to fight stigma and discrimination associated with this outbreak."

Find out more

Read up on the 15 simple monkeypox facts you need to know and also visit our article summarising the way in which monkeypox spreads, symptoms, prevention of infection and more.

Get your facts from reliable sources

Keep up to date on monkeypox:

1. In South Africa, on the NICD website
2. Globally:
   • WHO disease outbreak news
   • Monkeypox global health
   • ECDC situation update
   • CDC US Map and Case Count