The global spread of monkeypox has been declared a Public Health Emergency of International Concern by the World Health Organisation. The agency has made a declaration without the approval of the panel before.
A global health expert at the London School of Economics says that this is a big decision by the director general.
A majority of the Emergency Committee voted against declaring the monkeypox outbreak in more than 70 countries aPHEIC. The director general of the WHO invoked aPHEIC at a press conference today. He said that there was an outbreak that had spread around the world quickly through new modes of transmission.
Despite the inability of the advisory committee to reach a consensus, the WHO director made the decision to declare the MPXV aPHEIC, according to a letter written by a researcher. It was the right thing to do a month ago, when we were frustrated by the delay.
In June, the committee recommended against declaring aPHEIC, a move that was widely criticized by epidemiologists and global health experts. The group was asked to reconsider the question by Tedros in a 7 hour meeting. Tedros said at the press conference that 9 members were against declaring a PHEIC.
Lawrence Gostin is a health policy expert at Georgetown University Law Center. The risk of spread to other countries and the need for international coordination are some of the criteria for a PHEIC. The window for monkeypox to be contained outside of endemic areas in Central and West Africa is rapidly closing.
The Thursday meeting of the expert panel was followed by tense emails and text messages between those who had taken part.
The committee objected to aPHEIC because it had caused few deaths so far and was not spreading in the general population, as well as because it could lead to further stigmatization of men who have sex with men.
Some members of the committee noted that many advocates for gay rights and sexual health in MSM have advocated for aPHEIC to help raise awareness and protect those most vulnerable. Tedros said that the outbreak was focused on men who have sex with men, especially those with multiple sexual partners. This is an outbreak that can be stopped with the correct strategies.
The rising number of monkeypox cases, more than 15,000 so far, and countries affected, were cited by those in favor of declaring a PHEIC. There is a risk that the virus will establish itself in the global human population. The CDC reported yesterday that two children in the US had the illness.
Sources familiar with the deliberations of the committee said the votes for a PHEIC were driven by people with expertise in monkeypox and LGBT health.
The loudest alarm bell the organization can ring is given by a phEIC. Gostin says that declaring aPHEIC makes governments and the global public notice. The political stakes for government leaders are raised and the level of accountability is raised. The tool was created by the International Health Regulations in 2005 and has been used for six different types of infectious diseases. The EICs for the two diseases are still going on.
It shows how inconsistent the process is when the committee can't agree on declaring a PHEIC even though the legal criteria have been met. She says it's a problem. Governments need to trust that the process is the same each time, for it to have the power we want it to have.
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