During a meeting of the International Health Regulations (IHR) Emergency Committee in February 2023 on the mpox outbreak, the current infection rates and containment measures were considered alongside plans for the future. Although the Committee commended global efforts, it elected to continue to classify mpox as a PHEIC while “beginning to consider plans to integrate mpox prevention, preparedness, and response” into national surveillance and control programmes.  

Dr Tedros Adhanom Ghebreyesus 

Dr Tedros Adhanom Ghebreyesus, Director General of WHO, described the decline in cases as “very pleasing”. Since the PHEIC was declared, “affected countries” have demonstrated “hard work” in what he believes to be a “sustained decline”.  

“More than 85,000 cases of mpox have now been reported to WHO, with 92 deaths.”  

Despite the progress, “more than 30 countries” reported last month. The majority of cases are from the Regions of the Americas. In his remarks, Dr Adhanom Ghebreyesus also noted that it is “difficult to chart the true trajectory of the epidemic in the African Region due to the limited data available”.  

“Data sharing remains critical for all countries.”  

He suggested that, regardless of the decision made by the Committee, “bringing the outbreak to an end still requires intense effort”. Furthermore, we “must remember” that mpox has been “endemic in many low-income countries in Africa for many years”. Thus, as we force it out of countries that have “not seen major outbreaks before”, the outbreak “must spur sustained investment in addressing this disease everywhere”.  

The Committee convenes 

During the meeting the Committee acknowledged progress but identified “several concerns”. These include: 

  • Ongoing transmission in some regions 
  • Insufficient evidence regarding vaccine effectiveness on the individual and population levels and duration of immunity, either disease or vaccination-induced 
  • A potential shift in some countries towards the most marginalised populations who have the least access the prevention measures and treatments 
  • The possibility that behaviour change is not sustained in the long run 
  • Reduced surveillance and lack of reporting of cases to WHO, particularly in countries where the disease is endemic 

Despite these concerns, the Committee noted that the global risk is “moderate” and that “the predominant mode of transmission remains through direct and sexual contact”. Thanks to “community engagement activities” transmission has declined in many areas. However, there are concerns about the “possible resurgence of cases in some regions”, due to “seasonal differences” and “the resumption of events and other mass gatherings” as well as inequities in vaccine distribution and testing.  

“The Committee advised maintaining PHEIC”. 

For more discussion on the containment and prevention of mpox at the World Vaccine Congress in Washington, get your tickets now.