Geneva, Switzerland — 14 August 2024 — World Health Organization Director-General Dr Tedros Adhanom Ghebreyesus determined today that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005). The declaration came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data from WHO and affected countries.
The Committee informed the Director-General that it considers the upsurge of mpox to be a PHEIC, with potential to spread further across countries in Africa and possibly outside the continent. This is the second PHEIC relating to mpox in two years, following the multi-country outbreak declared in July 2022 and ended in May 2023.
A New and More Virulent Strain
The primary driver of the emergency declaration is the emergence and rapid spread of a new virus strain in the DRC — clade Ib — which appears to be spreading mainly through sexual networks. Its detection in countries neighbouring the DRC that had not previously reported mpox is especially concerning.
Dr Tedros stated: "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it's clear that a coordinated international response is needed to stop these outbreaks and save lives."
The Scale of the Outbreak
Mpox has been reported in the DRC for more than a decade, with the number of cases increasing steadily over that period. In 2023, reported cases increased significantly. By the time of the PHEIC declaration, the number of cases reported in 2024 had already exceeded the previous year's total.
The disease is caused by an Orthopoxvirus and was first detected in humans in 1970 in the DRC. It is considered endemic to countries in central and west Africa. Several outbreaks of different clades of mpox have occurred simultaneously in different countries, with different modes of transmission and different levels of risk.
Africa CDC's Regional Declaration
The WHO declaration aligned with a regional declaration made by the Africa Centres for Disease Control and Prevention (Africa CDC) on 13 August 2024, which designated the mpox outbreak a public health emergency of continental security — the first such declaration in Africa CDC's history.
Dr Matshidiso Moeti, WHO Regional Director for Africa, said: "Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to help reinforce measures to curb mpox. With the growing spread of the virus, we're scaling up further through coordinated international action to support countries bring the outbreaks to an end."
The Committee's Warning
Professor Dimie Ogoina, Chair of the IHR Emergency Committee, delivered a pointed assessment of the global response to mpox to date: "The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."
Vaccine Access and Emergency Use Listing
Two vaccines currently in use for mpox are recommended by WHO's Strategic Advisory Group of Experts on Immunization and are approved by WHO-listed national regulatory authorities, as well as by individual countries including Nigeria and the DRC.
In the week preceding the declaration, the Director-General triggered the process for Emergency Use Listing for mpox vaccines. This mechanism accelerates vaccine access for lower-income countries that have not yet issued their own national regulatory approval. Emergency Use Listing also enables partners including Gavi and UNICEF to procure vaccines for distribution.
| Response Element | Status as of 14 August 2024 |
|---|---|
| PHEIC declaration | Declared by WHO Director-General |
| Africa CDC declaration | Public health emergency of continental security (13 Aug) |
| Clade Ib spread | 4 neighbouring countries newly affected |
| Total cases (2024) | Over 15,600 cases, 537 deaths |
| Vaccines recommended | 2 (by SAGE) |
| Emergency Use Listing | Process triggered for mpox vaccines |
| WHO initial funding need | US$ 15 million |
| Contingency Fund released | US$ 1.45 million |
Funding and International Response
WHO anticipated an immediate funding requirement of an initial US$ 15 million to support surveillance, preparedness, and response activities. A needs assessment was being undertaken across the three levels of the Organization.
To allow for immediate scale-up, WHO released US$ 1.45 million from the WHO Contingency Fund for Emergencies and indicated it may need to release more in the coming days. The Organization appealed to donors to fund the full extent of needs of the mpox response.
WHO is working with countries and vaccine manufacturers on potential vaccine donations and coordinating with partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics, and other tools.
Understanding the Clades
The mpox virus has two main clades: clade I, historically found in the Congo Basin, and clade II, historically found in West Africa. Clade I is generally associated with more severe disease and higher mortality. The 2022 global outbreak was caused by clade IIb.
The new clade Ib is a variant of clade I that appears to have emerged in 2023 and is spreading rapidly through sexual networks in eastern DRC. Its detection in Burundi, Kenya, Rwanda, and Uganda — countries that had not previously reported mpox — signals a geographic expansion that the Emergency Committee deemed sufficient to trigger the highest level of international alarm.
The Path Forward
The Director-General committed to sharing the report of the Committee's meeting and issuing temporary recommendations to countries based on the Committee's advice. These recommendations typically cover surveillance, laboratory testing, risk communication, infection prevention and control, cross-border collaboration, and equitable access to medical countermeasures.
The PHEIC declaration was subsequently lifted by WHO in September 2025, after sustained declines in case numbers and improved outbreak control. However, mpox remains endemic in several African countries, and public health authorities continue to stress the need for vigilance, investment in surveillance, and equitable access to vaccines and diagnostics for the most affected populations.
Sources
- World Health Organization, "WHO Director-General declares mpox outbreak a public health emergency of international concern," 14 August 2024 —
- World Health Organization, Disease Outbreak News DON528 —
- United Nations News, "WHO declares mpox outbreak in Africa a public health emergency," 14 August 2024 —
- Health Policy Watch, "WHO ends international emergency declaration for mpox but vigilance still needed" —
FIRAT Editorial Board
Institutional Research Desk · Foresight Institute of Research and Translation
The collective editorial and research translation board of FIRAT, synthesising peer-reviewed evidence, policy briefs, and division milestones across our seven foundational research pillars.
