Resource & Access Challenges Constrain Mpox Response As WHO Elevates It To Public Health Emergency of International Concern (PHEIC)

Newsletter Edition #226 [The Files In-Depth]

Hi,

In today’s edition, my colleagues and I, bring you a comprehensive update on the international response to the Mpox health emergency in Africa.

This unfolding emergency reveals the shortcomings in the prevailing health emergency architecture. At this moment in time, in the long-winding negotiations to reform global health law to better respond to emergencies, this event brings into sharp focus the vexatious issues including agreeing on legal obligations on commitments on financing, and ensuring the access to medical products, among others.

Thank you for reading.

---

If you find our work valuable, become a paying subscriber. Tracking global health policy-making in Geneva is tough and expensive. Help us in raising important questions, and in keeping an ear to the ground. Readers paying for our work helps us meet our costs.

Our gratitude to our subscribers who ensure we stay in the game!

---

Until later.

Best,

Priti

Feel free to write to us: patnaik.reporting@gmail.com, Follow us on X: @filesgeneva

---

Illustration Credit: Amy Clarke, Chembe Collaborative

I. STORY OF THE WEEK

Resource & Access Challenges Constrain Mpox Response As WHO Elevates It To Public Health Emergency of International Concern (PHEIC)

By Priti Patnaik & Yukta Nagraj

Bhadra G contributed to this story.

---

Close on the heels of Africa CDC declaring mpox as a public health emergency of continental security on August 13, WHO elevated the outbreak in the Democratic Republic of Congo and a growing number of African countries, to a Public Health Emergency of International Concern (PHEIC). For now, the international response to the emergency is hemmed in by inadequate access to financial resources, and the access to medical products including vaccines and diagnostics.

The decision to declare the outbreak as a PHEIC was taken following a meeting of the Emergency Committee on August 14. The rules applicable to the emergency are those enshrined in IHR (2005). Officials clarified that the recently amended IHR in June 2024, do not come into force until after 12 months after the amendments are notified to state parties. (This is now in process.) This means that the new equity related obligations negotiated and agreed to in this process, will not apply to the latest mpox emergency.

The disease caused by an Orthopoxvirus, considered endemic to countries in central and west Africa, first detected in 1970 in the DRC, has affected a few countries with more than 15000 cases and 500 deaths in 2024 alone. (Already the number of cases reported so far this year has exceeded last year’s total.)

In his remarks, Tedros said in a late evening press briefing, “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.”

In a press statement, WHO said, “…the declaration came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data presented by experts 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. The Director-General will share the report of the Committee’s meeting and, based on the advice of the Committee, issue temporary recommendations to countries.”

This PHEIC determination is the second in two years relating to mpox. In July 2022, the multi-country outbreak of mpox was declared a PHEIC as it spread rapidly via sexual contact across a range of countries where the virus had not been seen before. That PHEIC was declared over in May 2023 after there had been a sustained decline in global cases, WHO said in the statement.

This story looks at financing, access and other issues in detail.

Image Credit: Photo by Steve Johnson, Pexels