The Director-General of the World Health Organization (WHO) has released the report from the second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the mpox outbreak of 2024. The meeting took place on November 22, 2024, from 12:00 to 17:00 CET.
Despite progress in response efforts, the Committee highlighted rising mpox cases and the geographical spread, particularly involving monkeypox virus clade Ib. Operational challenges and the need for strengthened national commitments and coordinated international action were underscored. The Committee advised that mpox continues to meet the criteria for a Public Health Emergency of International Concern (PHEIC) and provided recommendations for response measures.
The Director-General concurred with the Committee’s assessment and issued revised temporary recommendations to guide global efforts in managing the outbreak.
Meeting Proceedings
Sixteen Committee members and two advisors participated in the meeting, held via teleconference. Government representatives from five affected countries—Burundi, the Democratic Republic of the Congo (DRC), Kenya, Rwanda, and Uganda—were invited to share updates on the situation in their regions.
Global Situation and Challenges
The WHO Deputy Director-General noted the evolving complexities of the mpox outbreak since the declaration of the PHEIC in August 2024. Mpox cases have been reported in all six WHO regions, with significant outbreaks in the African and Western Pacific Regions. Transmission of clade Ib is particularly concerning, with community spread occurring in the DRC and neighboring countries such as Burundi, Uganda, Kenya, and Rwanda.
Key challenges include limited surveillance, laboratory diagnostics, contact tracing, and community engagement. Inconsistent implementation of interventions and competing health priorities have hindered progress, necessitating stronger political commitment and resources.
International Spread
Travel-related cases linked to clade Ib have been detected in eight countries across four WHO regions. The outbreak dynamics have shifted, with transmission expanding beyond commercial sexual networks to households and broader communities, including children.
The WHO assessed clade Ib as posing a high risk to public health and significant potential for national and international spread.
Response Efforts and Recommendations
The WHO outlined ongoing global efforts to combat mpox, including:
- Collaborative surveillance and clinical care initiatives.
- Equitable allocation of vaccines and diagnostics through the Access and Allocation Mechanism.
- Deployment of resources to affected regions.
- Strengthened coordination between WHO and Africa CDC.
Despite these efforts, vaccination coverage remains low in affected regions, and logistical and regulatory challenges persist. The Committee discussed the need for targeted vaccination strategies, particularly in high-risk areas, and addressing vaccine hesitancy.
