LONDON – The World Health Organization said Thursday that the global outbreak of mpox, which initially baffled experts when the smallpox-related disease spread to more than 100 countries last year, is no longer an international emergency, after a dramatic drop in cases in recent months.
Last July, WHO Director-General Tedros Adhanom Ghebreyesus declared mpox, also known as monkeypox, to be an “extraordinary” situation that qualified as a global crisis. In doing so, he overruled WHO’s expert committee, which didn't recommend the emergency designation.
Tedros said the novel way mpox was infecting people, via sexual contact in many countries that had never before identified cases, raised numerous concerns that warranted more attention; nearly all cases were in men who were gay, bisexual or had sex with other men. It was the biggest-ever outbreak of mpox.
He said at a media briefing on Thursday that his expert committee had concluded that the recent dramatic decline in cases, with about 90% fewer cases in the last three months, was no longer an acute concern.
“We now see steady progress in controlling the outbreak based on the lessons of HIV and working closely with the most affected communities,” Tedros said. “I’m pleased to declare that the mpox is no longer a global health emergency.” He added that the feared backlash against the communities most affected by the outbreak “has largely not materialized.”
The announcement Thursday comes after WHO downgraded COVID-19 last week, when it said the worst part of the pandemic was over and that the coronavirus should be managed like other respiratory diseases.
Mpox has been established in parts of central and west Africa for decades, where people are mainly infected by animals like wild rodents. But the disease wasn't known to spark big outbreaks beyond the continent or to spread easily among people until last May, when dozens of epidemics emerged in Europe, North America and elsewhere.
Mpox most often causes symptoms including a rash, fever, headache, muscle pain and swollen lymph nodes. The skin lesions can last up to a month and the disease is spread via close physical contact with an infected patient or their clothing or bedsheets. Most people don't need medical treatment to recover.
Scientists ultimately concluded that the unprecedented outbreak was tied to sex among gay and bisexual men at raves in Spain and Belgium, marking a significant departure from the mpox’s typical pattern of spread in Africa, where outbreaks haven't spilled across borders.
Shortly after Tedros classified monkeypox as a global emergency last year, the epidemics in Europe and North America declined, and there were no signs of widespread transmission beyond men who were gay, bisexual or had sex with other men. European health authorities said that 98% of mpox patients are men and of those, 96% are men who have sex with men.
Mpox vaccines in rich countries were quickly rolled out and reports of severe illness were relatively rare. Cases have since slowed to a trickle in Europe and North America. To date, WHO says there have been more than 87,000 cases and 140 deaths worldwide. Still, in the last week, WHO said cases spiked by 64% compared to the previous week, with most cases in the Americas and the Western Pacific.
The U.S. has reported the biggest outbreak, with more than 30,000 cases. This week, the U.S. Centers for Disease Prevention and Control said that it was investigating a recent surge in cases around the country, including Chicago. Scientists have previously warned mpox could become entrenched as a new sexually transmitted disease, as authorities said its spread could continue indefinitely in certain populations.
In central and west Africa, mpox cases are continuing to rise, mainly driven by a spike in Congo. WHO said there has been about a 7% jump in new infections in the last two weeks, and Tedros said the routes of transmission were still not well understood. Cases have also been reported in the Central African Republic, Nigeria, Liberia and Ghana.
While rich countries including Britain, the U.S. and Germany rushed to vaccinate their at-risk populations after the mpox outbreak emerged, Africa didn't receive its first big shipment of vaccines until last December.
WHO emergencies chief Dr. Michael Ryan criticized the global community for its failure to support the effort to contain the epidemic last year.
“Not one dollar was received from donors to support this response,” he said. He said that WHO had financed such efforts itself and acknowledged that some donors may have directly supported affected countries. “I was quite stunned to think that we could not get any funding for mpox.”