International locations which can be United Nations members are obligated to report instances of surprising ailments which have the potential to turn out to be international well being threats. In Might 2022, greater than a dozen nations in Europe, the Americas, and different areas of the world that had by no means earlier than had instances of monkeypox started to report instances occurring inside their borders.
Monkeypox is a uncommon illness attributable to an infection with the monkeypox virus, which is a part of the identical household of viruses as variola virus, the virus that causes smallpox. Monkeypox signs are just like smallpox signs, however milder, and infrequently deadly. Monkeypox just isn’t associated to chickenpox.
In response, Tedros Adhanom Ghebreyesus, the director-general of the World Well being Group, convened a monkeypox emergency committee to trace the evolving scenario. On the committee’s first assembly on June 23, 2022, the members believed that the “multi-country outbreak” may be stabilizing as case counts had plateaued in a number of nations.
Nevertheless, after hundreds extra instances of monkeypox had been identified in dozens of nations in July, it turned clear that the outbreak had not leveled off. On July 23, 2022, Tedros declared monkeypox a public well being emergency of worldwide concern.
As a international well being knowledgeable who focuses on infectious illness epidemiology I don’t suppose that most individuals must be nervous about monkeypox. Athough it might sound ominous, this choice by the WHO just isn’t an indication of dangerous issues to return. Quite, it’s a approach to stop monkeypox from turning into a worldwide disaster.
What’s a public well being emergency of worldwide concern (PHEIC)?
The Worldwide Well being Laws are a algorithm that information how the WHO and United Nations member states reply to rising well being threats.
Below the present rules, a “public well being emergency of worldwide concern” – usually abbreviated as a PHEIC – will be declared by the WHO director-general when three standards are met: the scenario is an “extraordinary occasion,” there’s a danger of unfold to different nations, and the scenario might “probably require a coordinated worldwide response.”
Earlier than monkeypox, solely 5 ailments had been designated as PHEICs for the reason that WHO began utilizing the time period in 2005: the H1N1 influenza pandemic in 2009; polio resurgences in Afghanistan, Nigeria, and Pakistan in 2014; the Ebola epidemic in Guinea, Liberia, and Sierra Leone in 2014 and an Ebola outbreak within the Democratic Republic of Congo 2019; the unfold of Zika virus within the Americas in 2016; and the COVID-19 pandemic in 2020. While all of these events were noteworthy, only the coronavirus pandemic became a worldwide catastrophe.
Why is monkeypox a public health emergency of international concern?
Although the director-general of the WHO is the only person who can declare a PHEIC, the decision is based on advice from the designated emergency committee. After the monkeypox emergency committee met for the second time, on July 21, 2022, it released a report stating that “the multi-country outbreak of monkeypox meets all the three criteria defining a PHEIC.”
The rapid spread of the virus to more than 70 countries was strong evidence of the risk of further international spread. Also, the committee expressed concerns about whether vaccines would be priced reasonably and distributed equitably in the absence of a coordinated international response. Furthermore, it agreed that there were aspects of the situation that were “extraordinary” – a vague term that is not defined in the International Health Regulations.
However, the committee was not in unanimous agreement that a public health emergency of international concern should be declared. Some members questioned whether a disease that has a low case fatality rate should be a PHEIC. Others worried that a PHEIC designation could further stigmatize LGBTQ communities because most cases thus far have been diagnosed among men who have sex with men.
The vote from the emergency committee was split – nine against and six for PHEIC status. However, Director-General Tedros opted to go ahead and declare monkeypox a PHEIC.
What happens now?
The goal of a PHEIC designation is to prevent an emerging disease from becoming a global health crisis. The WHO has two initial goals for monkeypox. First, to try to stop the virus from beginning to circulate in susceptible populations where it is not currently present. And second, to distribute vaccines and antiviral medications to the countries and communities that need them most.
After the PHEIC declaration, the WHO released a set of temporary recommendations that asks countries to work harder on preventing cases in affected and at-risk communities, to improve clinical care for people with monkeypox, and to contribute to research on vaccines and treatments for monkeypox. The recommendations also ask countries to advise infected individuals and their direct contacts not to travel except in urgent situations, but they do not impose any restrictions on international travel or trade.
Finally, the WHO has advised that individuals who are members of at-risk communities take steps to protect themselves from the virus, but has not called for changed behavior in the general public.
A public health emergency of international concern is the highest level of alert in the International Health Regulations, but it is not a synonym for a pandemic. The status is a tool for protecting global population health and not a declaration that a global crisis is already happening.
Written by Kathryn H. Jacobsen, William E. Cooper Distinguished University Chair, Professor of Health Studies, University of Richmond.
This article was first published in The Conversation.