Global Health Alert: WHO Declares Continued Public Health Emergency Amidst Escalating Mpox Crisis in 2025

The latest statistics reveal that from January 2022 to January 2025, nearly 130,000 confirmed Mpox cases and over 280 deaths have been reported across 130 countries.

The Director-General of the World Health Organization (WHO) has reaffirmed that the ongoing upsurge of Mpox 2024 continues to meet the criteria of a Public Health Emergency of International Concern (PHEIC). This decision follows the third meeting of the International Health Regulations (2005) (IHR) Emergency Committee, held on February 25, 2025, to assess the global epidemiological situation of Mpox and recommend strategic responses.

The Ongoing Mpox Crisis: A Global Public Health Threat

The latest statistics reveal that from January 2022 to January 2025, nearly 130,000 confirmed Mpox cases and over 280 deaths have been reported across 130 countries. The majority of these cases—61%—have emerged from the WHO African Region, which also accounts for 72% of global Mpox-related deaths.

Despite efforts to contain the outbreak, including enhanced emergency coordination, surveillance, and vaccination campaigns, several key challenges remain. WHO experts highlight geopolitical instability, concurrent health emergencies, and a significant shortfall in financial resources as critical obstacles to the response efforts.

Key Challenges Affecting the Response

1. Conflict in the Democratic Republic of the Congo (DRC):

   • Ongoing violence and instability in eastern provinces have disrupted Mpox response operations.
   • The relocation of healthcare workers and restricted access to affected populations have hampered containment measures.

2. Competing Health Emergencies:

   • The simultaneous outbreak of the Sudan virus disease in Uganda and other regional health crises have divided attention and resources.

3. Financial Constraints and Funding Freeze:

   • A significant pause in financial assistance from the United States, which had contributed one-third of global Mpox response funding, has created a major funding gap.
   • This financial shortfall has impacted diagnostic testing, vaccine distribution, and emergency response efforts, particularly in Burundi, Rwanda, the Central African Republic, and the Republic of the Congo.

Mpox Spread and Clade Analysis

The WHO Secretariat provided a comprehensive update on the spread of different clades of the Mpox virus:

• MPXV Clade Ib:

  • Predominantly spreading in the DRC, Burundi, and Uganda, with over 15,000 reported cases in the DRC alone.
  • Mathematical modeling suggests a decline in transmission in certain regions, such as North Kivu and South Kivu, due to vaccination efforts.
  • Increasing reports of child-to-child transmission in Burundi, raising concerns over the potential for wider community spread.

• MPXV Clade Ia:

  • Circulating primarily in the DRC with high case fatality rates (2.5–3%), particularly among infants under one year old.
  • The WHO is monitoring the emergence of new sub-lineages within Clade Ia in Kinshasa, which could have enhanced human-to-human transmission capabilities.

• MPXV Clade IIb:

  • The dominant clade outside of Africa, with recent declines in reported cases.
  • Travel-related imported cases detected in 14 countries since the Committee’s last meeting.

Impact of the Crisis on Vulnerable Populations

The transmission dynamics of the outbreak have shifted significantly over time:

• Sexual Networks and Commercial Sex Work:

  • Initial spread among commercial sex workers and long-distance truck drivers in Uganda, later extending to broader social networks.
  • Concerns over increased transmission within more affluent communities, raising the risk of international spread.

• Children and Healthcare Settings:

  • Alarming infection rates among young children (0–9 years) in Burundi, potentially linked to healthcare settings.
  • Lack of evidence supporting large outbreaks in childcare or school environments, but ongoing surveillance remains crucial.

Global Response and Future Directions

1. Vaccine Distribution and Access:

   • The WHO-led Access and Allocation Mechanism (AAM) continues efforts to expand equitable vaccine distribution.
   • Nigeria has administered 20,000 vaccine doses, prioritizing healthcare workers, female sex workers, and men who have sex with men.
   • Uganda has launched targeted vaccination campaigns for sex workers in Kampala, following increased community transmission.

2. Enhanced Surveillance and Testing:

   • The funding freeze has impacted diagnostic capabilities, particularly in the DRC, reducing testing rates and potentially underreporting the true scale of the outbreak.
   • WHO and local governments are working to mobilize alternative funding sources to maintain laboratory operations.

3. Travel and Border Controls:

   • Travel-related imported cases in the United Arab Emirates, Canada, China, and the United Kingdom signal a need for strengthened international surveillance.
   • Countries of origin are being systematically informed to improve contact tracing and containment.

Future Considerations and WHO’s Strategic Plan

The WHO’s Mpox Global Strategic Preparedness and Response Plan (SPRP), initially set to conclude in February 2025, is being extended to continue guiding containment efforts. However, the organization warns of critical funding shortages that could jeopardize ongoing progress.

The WHO Emergency Committee has also raised concerns about the prolonged classification of Mpox as a PHEIC, cautioning that maintaining this status indefinitely may undermine the effectiveness of global public health alerts in the future.

Final Recommendations and the Path Forward

Based on the deliberations, the WHO Committee has advised the following actions:

• Increased financial support and donor engagement: Address funding shortfalls to sustain response activities.
• Enhanced global cooperation: Strengthen international coordination, particularly in high-risk regions.
• Targeted vaccination efforts: Prioritize high-risk groups, including healthcare workers, sex workers, and individuals in endemic regions.
• Comprehensive public health communication: Improve awareness campaigns to reduce stigma and encourage early reporting of cases.

The WHO Incident Manager for Mpox expressed gratitude to all partners involved in the ongoing response, emphasizing the need for sustained vigilance and collaboration to curb the outbreak and prevent further spread.

As global health authorities continue their fight against Mpox, the world watches closely, hoping that strengthened international efforts will lead to better containment and, ultimately, the end of this public health emergency.

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