The surge in mpox, or monkeypox, cases in parts of Africa has led to the World Health Organization (WHO) declaring the outbreak of the viral disease a public health emergency of international concern on August 14. Dr Javier Guzman, director of Global Health Policy at the Center for Global Development, in an interview with Rhythma Kauldiscusses how the West should respond to the ongoing threat, the importance of guaranteeing safe and equitable access to vaccines, and the need to improve global systems for pandemic preparedness and response among other things. Edited excerpts:
Do you think the current mpox situation warrants to be labelled as global public health emergency?
I fully support the World Health Organization’s decision to declare the mpox outbreak a public health emergency of international concern. This outbreak involves a new, deadlier strain of the mpox virus that is more easily transmitted between humans compared to the 2022 strain. Moreover, this new strain is not limited to a specific population — such as men who have sex with men — and is spreading rapidly beyond the Democratic Republic of Congo (DRC) to other African countries and beyond, with the first case outside the continent recently detected in Sweden.
By declaring the outbreak a public health emergency of international concern, WHO, along with regional and national institutions, can more effectively mobilise funds and resources to combat the spread, while encouraging countries to enhance their surveillance and preparedness efforts.
What immediate measures are needed to check the outbreak?
The top priority right now is to establish a coordinated international response to the epidemic and support affected African countries to contain the outbreak. This includes ramping up contact tracing, enhancing surveillance, and ensuring that vaccines already approved in high-income countries are made available. Currently, the Africa CDC (Centres for Disease Control and Prevention) estimates that 10 million vaccine doses are needed across the continent, yet only around 200,000 doses have been provided so far.
Is the global response adequate to help Africa deal with the outbreak?
No, the response is not sufficient, and additional resources and support are urgently needed. A coordinated international effort is essential to effectively tackle the epidemic, with increased support for affected African countries to contain the outbreak.
What long-term measures are needed to solve this problem?
Moving forward, we need to take additional steps to strengthen how countries prevent, prepare for, and respond to outbreaks. Two key measures can improve the speed and effectiveness of the system: First, countries should set aside funds that can be quickly used when a public health emergency is declared. This is known as surge financing and ensures that there are enough resources ready to buy medical supplies and make necessary investments for a fast, fair, and coordinated global response. Despite global leaders, including those in the G7 and G20, acknowledging this need, concrete action has yet to be taken.
Second, it is crucial to decentralise decision-making and boost the capacity of organisations like the WHO. For example, Gavi (global alliance for vaccines and immunisation) has a $500 million first response fund, but it remains unused because it requires WHO’s approval for mpox vaccines, even though these vaccines are already approved by other top regulatory bodies. This process needs updating. Gavi and other global health initiatives should adjust their policies to recognise approvals from WHO-listed authorities, a new system that identifies top-performing regulatory bodies.
How effective are the vaccines against mpox?
Two existing vaccines are effective when administered to people at risk before they come into contact with the virus. This is why African countries urgently need a large supply of vaccines to protect those most vulnerable — in this outbreak, that could include sex workers, children, and adults living in areas with a high number of cases.
Can the disease be eliminated in near future or will the world have to live with it?
Completely eliminating mpox is difficult because the virus exists in animals and can spread to humans. However, with strong global efforts, we can significantly reduce human cases and control outbreaks.
