While recovering from the COVID-19 pandemic and dealing with its health, social, and economic consequences, the world is now facing a new-old threat which is making the news headlines. After more than 17,000 cases of mpox (formerly known as monkeypox) have been reported in 75 countries, the UN’s World Health Organization (WHO) has declared the disease to be a global health emergency – the highest level of alert. The monkeypox virus, which causes mpox, started to spread around the world in 2022 and had been circulating among humans since then before this new explosion of cases led to the recently declared global health emergency. Could mpox become a threat leading to the next pandemic? Check some opinions below.
Key Takeaways:
- Since January 2024 around 520 deaths caused by the monkeypox virus have been reported – a fatality rate of 3%.
- According to experts, mpox is less likely to become a global pandemic due to the fact that it primarily spreads through close physical contact, limiting its rapid global transmission.
- Informing the public about the virus’s symptoms, transmission methods, and preventive measures is essential to prevent its spread.
- To prevent a global health crisis, it is necessary to ensure equitable access to vaccines, improve local health infrastructure, and support international collaboration.
DevelopmentAid: Could mpox become a threat leading to another pandemic? What measures should the WHO take to prevent this, and what are your recommendations for the population?
“As an expert in global health, it’s clear that the mpox outbreak, especially with the emergence of the new, more dangerous subtype (Clade I), poses a significant threat. The WHO’s declaration of mpox as a Public Health Emergency of International Concern is a poignant reminder of our interconnected world, where the threads of disease can weave their way across continents with unsettling speed. For WHO, the path forward demands a concerted effort on several fronts. Strengthening global surveillance systems is crucial to improve the ability to detect and respond to outbreaks promptly, particularly in regions with inadequate infrastructure for case detection and testing. Equally pressing is the equitable distribution of mpox vaccines; a fair approach is essential to ensure that every community, regardless of its wealth, has access to protection against this virus.
For the public, the best preventive measures include avoiding close contact with anyone showing symptoms, maintaining good hygiene, and staying updated with information from reliable health sources. Public health education and health communication must also get engaged in the contamination prevention process. By disseminating clear, non-stigmatizing information about mpox – its symptoms, its modes of transmission, and preventive measures – we can empower people to protect themselves and each other. This effort is not just about addressing the immediate threat but about fostering a sense of shared responsibility in our global village. As for the future, predicting whether mpox will escalate into a widespread global epidemic remains uncertain. Yet, history reminds us that infectious diseases move with the currents of human interaction and migration. We must remain vigilant and proactive, prepared to meet the virus wherever it travels and respond with resolve.”
“The lessons from COVID-19 and other Public Health Emergencies of International Concern (PHEICs) are invaluable. As we face the resurgence of mpox, it is critical to apply these lessons proactively. To prevent mpox from escalating, the following actions are essential:
- Data Integrity: Accurate data is the foundation of effective decision-making. It is crucial to ensure the quality and reliability of data, particularly when comparing the impact of various factors such as diseases, insecurity, and weak health systems on affected populations.
- Comprehensive Response: One-size-fits-all interventions are insufficient in complex crisis settings. All those involved must adopt a holistic approach that addresses the multifaceted needs of communities, including safety, security, food, shelter, education, medical treatment and community support. These are not mere services but fundamental human rights that require sufficient resource allocation.
- Clarity and Accountability: Absolute clarity regarding intentions, target recipients, beneficiaries, and accountability mechanisms is non-negotiable. Transparency in terms and conditions and communication must be followed by concrete actions that align with these commitments.
By implementing these measures, the WHO can strengthen its response to mpox and mitigate the risk of another global pandemic. For the affected and populations, awareness and strengthening resilience are key to preventing the spread of the virus. Together, we can transform this challenge into an opportunity for healthier people, stronger health systems and increased resilience and effective and efficient outbreak management.”
“Mpox has the potential to disseminate extensively; however, it is less likely to cause a global pandemic comparable to COVID-19 due to a variety of factors. Mpox is predominantly transmitted through intimate physical contact, which may involve contact with body fluids, lesions, or contaminated materials. It is less probable that respiratory transmission will disseminate quickly on a global scale as it necessitates prolonged face-to-face contact. There are currently vaccines and therapies available for mpox. The smallpox vaccination offers partial immunity against mpox, although newer vaccines such as JYNNEOS (Imvamune or Imvanex) are also efficacious. WHO should increase its surveillance of mpox cases worldwide, particularly in non-endemic areas. This includes reliable contact tracing and reporting mechanisms. WHO has ensured that vaccinations were available and distributed in areas suffering outbreaks, with a focus on high-risk groups. This organization is also responsible for launching campaigns to foster cooperation among countries to educate the public on the spread of mpox and the significance of protecting themselves by avoiding contact with infected individuals and materials. The population should maintain good hygiene, including frequent handwashing, and avoid contact with individuals who have symptoms of mpox (such as rash or lesions). Additionally, it is important to stay informed with reliable information from public health authorities such as the WHO or the US Center for Disease Control and Prevention. Although mpox is a cause for concern, implementing proper measures can effectively contain its spread, hence reducing the possibility of it evolving into a worldwide pandemic.”
“While mpox is a serious disease, it is less likely to cause a pandemic on the scale of COVID-19. The transmission of the mpox virus is slower compared to respiratory viruses such as coronaviruses. It primarily spreads through close contact with an infected person, animal, or contaminated materials, which limits its potential for widespread transmission. However, the rise in cases and the virus’s ability to spread through human-to-human contact, especially in regions where it was not previously common, is concerning. Monitoring and controlling outbreaks is crucial to prevent escalation. WHO can support surveillance and monitoring, public health communication, vaccination, and treatment, and provide advisory services for travelers and trade, and specialized assistance for the affected regions. The agency should improve global surveillance to quickly identify and respond to mpox cases. This includes supporting those countries with limited resources to detect and report cases promptly. Clear and accurate information about mpox should be disseminated to avoid panic and misinformation. This includes educating the public on how the virus spreads and how it can be prevented. In addition, WHO should work with governments to ensure the availability of vaccines, especially for high-risk populations. Research into effective treatments should be supported. Countries experiencing outbreaks, particularly those with weaker health systems, should receive international support to manage and contain the virus. Moreover, WHO should provide recommendations for international travel and trade to prevent the spread of mpox without imposing unnecessary restrictions. Early diagnosis and treatment can help to prevent further spread. If you are in a high-risk group or live in an area with an outbreak, consider getting vaccinated if it is available. Be mindful of the stigma that can arise with infectious diseases. Focus on facts and compassion rather than fear.”
“In the light of the bold and quick declaration by the WHO of the mpox outbreak in the Democratic Republic of Congo (DRC) and several other countries as a Public Health Emergency of International Concern (PHEIC), this signals the ongoing risk and potential for wider transmission, and the determination of the WHO to prevent this developing infectious disease threat from turning into a global pandemic, guided by lessons learned during COVID-19. The emergence of the clade Ib variant, which exhibits increased transmissibility through close contact, raises legitimate concerns about the virus’s potential to escalate into a pandemic. Hence, the declaration by WHO gives us a clear sign of how serious the situation is. The WHO is doing a great deal following the declaration but needs to prioritize access to vaccines through their accelerated development, distribution, and use. This outbreak is an opportunity to implement the newly agreed revised and broad-scoped International Health Regulation (IHR, 2005) to achieve equitable access to vaccines, diagnostics, and therapeutics in resource-challenged countries. The countries that are affected have to activate their health emergency response systems, including the Public Health Emergency Operations Centers (PHEOCs). Improved surveillance, contact tracing, quarantine and isolation spaces, and the provision of social and psychosocial support remain key interventions. Promoting awareness about the modes of transmission, including hygienic practices such as avoiding close physical contact and respiratory droplets, empowers individuals to make informed choices, not forgetting about encouraging vaccination. In conclusion, while the WHO works to strengthen global health security against this threat, every country in the region must activate its emergency response, improve its preparedness and border surveillance, and share information with other countries. As the saying goes in West Africa, “when your neighbors’ beard is on fire, you must fetch water.” Sustained vigilance, coordinated public health action, and individual responsibility are crucial to prevent its escalation and safeguard global health security.”
“While mpox has been declared a public health emergency of international concern by WHO at the global level, its ability to lead to another pandemic like COVID-19 is still a debatable subject. The virus’s transmission dynamics, the availability of vaccines, and the global response to current outbreaks will play crucial roles in determining its impact. Continuous surveillance, preparedness measures, and effective communication strategies are essential to mitigate the risks associated with mpox. As the world struggles with the emergence of mpox, a viral disease with pandemic potential, it is crucial for both the WHO and the general population to take proactive measures to prevent its spread and mitigate its impact. The WHO is already playing a pivotal role in determining the impact of mpox. By improving surveillance, the organization is closely monitoring the situation and providing regular updates on the spread of mpox. This includes tracking cases, identifying new variants, and assessing the effectiveness of current measures. Ensuring that vaccines are available and accessible to high-risk groups, such as healthcare workers and men who have sex with men, is also crucial. Public awareness campaigns can educate people about the symptoms of mpox, how it spreads, and prevention measures, emphasizing the importance of hand hygiene, safe sexual practices, and avoiding contact with wild animals. For the general population, staying informed is key. Practicing good hygiene by washing hands with soap and water, especially after encountering someone who has mpox or their personal items, is essential. Safe sexual practices can reduce the risk of transmission. In areas where mpox is endemic, avoiding contact with wild animals and cooking animal products thoroughly before consumption can also help to prevent transmission. If you are in a high-risk group, consider getting vaccinated against the mpox virus. Consult with your healthcare provider to determine if you are eligible. If you have been diagnosed with mpox, isolate yourself from others until all lesions have crusted over and a new layer of skin has formed. By working together, we can prevent the spread of mpox and mitigate its impact.”
“The declaration of the mpox outbreak as a potential global health threat by WHO is a serious step, but it does not necessarily mean that it will develop into a pandemic. The virus spreads more slowly than highly contagious diseases like COVID-19 and requires close physical contact for transmission, limiting its spread compared to airborne viruses. However, the risk should not be underestimated. Given global travel and interconnectedness, the virus could spread widely, especially in densely populated areas with inadequate public health measures. However, the status attributed by the WHO opens the door for increased funding and research, both vital for containing the outbreak. Immediate actions should include strengthening the surveillance systems in affected and neighboring countries to monitor the virus’s spread and swiftly identify new cases. Vaccination campaigns, particularly in high-risk areas, could also help to curb the virus’s spread, as the existing smallpox vaccine is effective against mpox. Public education campaigns are essential to raise awareness about the symptoms, transmission, and prevention of mpox, enabling communities to protect themselves and seek early medical advice. Additionally, international collaboration is crucial for a coordinated and effective response to the outbreak. For the public, those in affected regions should avoid close contact with potential sources of transmission, such as infected individuals, contaminated materials, and animals, including bushmeat. Prompt medical advice should be sought if symptoms develop. Good hygiene practices, including frequent handwashing and using personal protective equipment, when necessary, are also important to reduce the risk of infection. In conclusion, while mpox is a significant public health challenge, it can be contained with the right measures. WHO’s proactive approach is essential to prevent another global health crisis, but success requires the cooperation of governments, health organizations, and the public.”
“The COVID-19 pandemic highlighted how interconnected our world is, and mpox serves as another reminder. In public health, the causes of disease are often categorized as immediate, underlying, and root to ensure that effective interventions are developed and implemented. The highest and most sustainable impact is achieved when root causes are addressed. In the case of mpox, the root cause is under development in regions identified as “sources” of these diseases. The real challenge, particularly for policymakers and leaders in these underdeveloped areas, including in Africa, is to address underdevelopment and the lack of peace and economic stability. This will lead to the establishment of locally led, locally-owned, and well-funded academic, scientific, and regulatory institutions to lead research into the prevention and alleviation of future pandemics. Unfortunately, we are more than 20 years behind in this regard. Closing this gap is essential for global health security, and this can only be achieved through genuine collaboration across all sectors, beyond the WHO. We need to be equally concerned about recurrent cholera outbreaks, the emergency of polio outbreaks, etc. but it all points to one issue – underdevelopment, the lack of peace and stability. The real question is – how can we accelerate progress towards attainment of the Sustainable Development Goals?”
“The rare viral zoonotic virus monkeypox (MPX) originated in Central and Western Africa and has spread to over 20 nations. Because it resembles smallpox and chicken pox, laboratory testing is needed to diagnose it. It is the most serious orthopoxviral infection since smallpox was eradicated in the 1970s and it threatens to transform into a pandemic. The 2022 multi-country MPX outbreak has enlisted worldwide surveillance bodies and epidemiologists to establish its etiology, but animal reservoirs, biological effects, and control remain unclear. Following these events, the WHO proclaimed mpox to be a worldwide health emergency. The Agency can take several precautions to limit the spread of the disease: (1) improving surveillance comes first. Increase passive and active surveillance. To stop the spread among uninfected people, efficient surveillance will identify and report cases, trace contacts, and quarantine. (2) The WHO must strengthen and raise awareness. For public mpox awareness, the risk communication and community engagement department must establish successful tactics. (3) Ensure an adequate quantity of mpox vaccines to stop its spread. Vaccines provide herd immunity and limit spread in susceptible populations. At the same time, preventing mpox transmission requires orchestrated efforts from the community, local authorities, and influencers. Thus, efforts must be focused towards limiting vaccination hesitancy, and practicing hand hygiene. Soapy handwashing stops viral transmission. Vulnerable communities should report unusual diseases to health authorities for quick investigation and treatment.”
“Mpox is an infectious disease, predominantly reported in sub-Saharan African countries and occurring mainly in rural areas where people have close contact with infected animals, such as rodents or monkeys, through hunting, handling, or consumption, among others. The virus could become a pandemic emergency due to its transmissibility and occurrence. The disease occurs frequently in countries with poor health surveillance, prevention, care, and treatment systems. However, despite efforts to strengthen health systems in Africa during and after COVID-19, they still face major challenges in terms of surveillance/diagnosis infrastructure, qualified human resources and financial resources for implementing vaccination programs.”
“The WHO’s declaration of mpox as a health issue of international concern should increase global vigilance. Although the routes of transmission are assumed to be just through direct physical contact with infectious fluids from the pox, some experts postulate the possibility of particles from the lesions travelling through the air as well. With a provisionally R0 of around 2 and a mortality estimated at 4% (somewhere between 1 and 11%) in the Democratic Republic of Congo, more data is necessary to discern the further implications for global/international health and the spread of the virus. The occurring fast advance to neighboring countries (Uganda specifically) does not bode well. To contain the epidemic geographically, international effort is necessary to discover index cases and to start (ring-)vaccination as soon as possible (although the risk is that we are beyond that stage). Uninhibited exponential increases risk the overload of even western health systems. Lessons might not have been sufficiently learned from the COVID-19 pandemic. The refusal of some Western countries to relinquish mpox vaccines from their national stocks for these purposes (including my home country, the Netherlands) demonstrates shortsightedness and inappropriate nationalism, seemingly not fully understanding the intention of the declaration by the WHO.”
“Early in 2024, few cases of mpox were reported, reaching June/July levels of public health emergency at the continental level (Africa, CDC declaration), while WHO considered it an outbreak: 934 cases across 26 countries. Other sources reported on local radio, hospital mortality rate around 3.4%. Such mortality rate should not be considered abnormal in our environment, due to endemic limited access to health system. Although few African countries (DRC, Burundi, Ivory Coast) reported cases, we are still below the highest mortality registered. The documented death rate is about 10 to 17%, far from the hospital lethality recently shared of 208 deaths out of 9,976 reported cases. Considering the historical discovery of this disease, Copenhagen published research on orthopoxvirus must be considered with better attention. Could such a threat be like COVID-19? No, because it spreads through biological fluids, contact with wild animals such as Gambian rats, dormice, and likely squirrels. A global call for vaccine supplies has been launched: 10 million doses are needed to limit the spread throughout Africa (Africa CDC recent call). In a wild context, overwhelmed by floods, malaria, and the HIV burden, the population should:
- Keep an eye on the new vaccine rollout.
- Follow the local institute of hygiene in charge of carrying out national policy responses.
- Avoid any type of practical exchange between human communities and wild animals (One Health).
- Ensure you are connected to validated news.
- Activate or maintain your social platform created during or before the COVID-19 response.”
“To stop the mpox outbreak as soon as possible, according to WHO initial estimates, about US$135 million will be needed in the next six months, during the acute phase of the disease,” said WHO Director-General Tedros Adhanom Ghebreyesus on August 23, 2024. He also noted that this amount could increase as the plan for needs is constantly updated to allocate more funds in the coming days until donor funding arrives. A mpox pandemic spreads slowly and only through direct contact (from animal-to-human and from human-to-human transmission). For populations, strict measures for the prevention of mpox (avoiding direct contact with contaminated patient, gowns, gloves, eye protection, N95 medical mask, etc.) should be developed. For diagnosis, PCR testing should be applied, the same as for COVID. Mpox is usually self-limited and may require only symptomatic treatment; however, it may cause severe complications. For severe infections, clinicians may consider antiviral drugs that were originally approved for smallpox treatment. Two smallpox vaccines: ACAM2000 and JYNNEOS can be used as pre-exposure prophylaxis and against mpox.”
See also: Is monkeypox the next big pandemic? (Part II) | Experts’ Opinions
As experts consider the possibility of mpox becoming a pandemic threat, it is crucial for professionals in the health sector to stay ahead of the curve. DevelopmentAid’s Individual Professional Membership offers a plethora of tools for experts to distinguish themselves in the international development job market. Members can access thousands of job openings in the aid field, organization and donor profiles, tenders, and grants for individuals, become more visible to member organizations (including being featured at the top of search results), receive discounts for CV Broadcast, and more.
