Group faults WHO’s declaration of Mpox as public health emergency

A coalition of Civil Society Organisations has criticised the World Health Organisation’s declaration of Mpox as a Public Health Emergency of International Concern (PHEIC).

Edet Williams, a member of the coalition under the aegis of Equity International Initiative, spoke on Monday during a press conference in Ikeja, Lagos. The press conference was themed “The WHO Declaration of MPOX as a Global Health Crisis: A Civil Society Response.”

Mpox is a rare viral zoonotic infectious disease most prevalent in Africa.

Nigeria has recorded 40 confirmed and 830 suspected Mpox cases across 33 states, including the FCT.

No death from Mpox, formerly called Monkeypox, has been recorded in Nigeria.

Across Africa, over 18,000 cases have been recorded in 12 countries, and over 3,000 have been confirmed. Over 500 deaths have been recorded.

On 14 August, WHO Director-General Tedros Ghebreyesus said that the upsurge in Mpox cases in the Democratic Republic of 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) (IHR).

Mr Ghebreyesus’ 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 considered the upsurge of Mpox cases to be a PHEIC, with the potential to spread further across countries in Africa and possibly outside the continent.

Also, Mpox was declared PHEIC in May 2020.

Low mortality rate

“All through 2023, we had a total of 98 confirmed cases of monkeypox … with two deaths in a country of 200 million people,” Mr Williams, a director at the Elite Medical Team, said.

He added, “Monkeypox is not new. We have two clades—one of Clade II is self-limiting (this means that you have it on Monday; if you do nothing until next Tuesday, it’s gone), and the most you get are rashes, fever, and headaches. Recently, we have had clade I and (subclade) Ib, which is now the concern and even in the clade, that is potentially fatal for those who have it.

“We have it in DRC, which is the most endemic. The maximum fatality rate you have is 3.5 per cent.

“Globally, we have about 3.2 per cent mortality rate. It’s a bit difficult to understand why this has become a major emergency that we need to look into.”

Meanwhile, according to WHO, Africa has recorded 5,940 cases of Mpox, with a total of 48 deaths between January 2022 and 18 August. Globally, there have been 102,997 reported cases with 223 fatalities from 1 January 2022 to 31 July.

Conditions for declaring public health emergency

According to WHO standards, Mr Williams said certain conditions must be met before Mpox can be declared a public emergency of international concern.

“Is the public health impact serious? In terms of the seriousness to morbidity and mortality, is the event unusual or unexpected?” he queried.

He noted that there is a need to review the present response mechanism.

He said that, in the past, public health education and surveillance were used to combat the outbreak of Mpox successfully.

“So, why are we out here now choosing another route that is going to cost us a whole lot more in a country that is bleeding for finance?”

Obielumani Ideh from Doctors’ Health Initiative also reiterated that Mpox does not meet the criteria of being declared PHEIC.

For it to be categorised as PHEIC, it has to be “serious, sudden, unusual or unexpected; carry implications for public health beyond the affected state’s national border, and may require immediate international action.”

She said before introducing vaccine treatment, Mpox was being tackled locally through public awareness, avoiding close contact with infected people or contaminated materials, and using gloves and other personal protective clothing while caring for the sick.

Ms Ideh also noted that Mpox is less serious than smallpox.

She added that of the two variants of clade I and II of Mpox, only the clade I virus is spreading in the Democratic Republic of Congo. She said the clade II variant is mostly found in West Africa.

Other members of the group include Segun Adebayo; Deputy Director Center for Food Safety and Agricultural Research, Patrick Ijewere, and Gold Boms.