The Significance of WHO Declaring Mpox a Global Emergency

This week there was both a declaration by Africa CDC that the ongoing mpox outbreak is a public health emergency of continental security and the World Health Organization's (WHO) declaration the disease is a global health emergency.

This is significant, international public health news, and Mitch Wolfe, MD, vice president of Global Engagement and Governance, Ginkgo Bioworks and former Chief Medical Officer at the CDC, was glad to see WHO make the announcement as it helps organize and coalesce officials, clinicians, and other stakeholders around fighting mpox.

“All member states of WHO that have signed on gives [those] countries certain obligations when there are outbreaks. What this declaration does is it provides for awareness; it provides countries with the ability to coordinate more; it releases resources, and it alerts countries that they need to be thinking about their responses. So, I'm really happy to hear that WHO declared this emergency and did it at a relatively early phase in this outbreak,” said Wolfe.

Wolfe says that what they know so far is both clades of mpox are typically transmitted by close contact. “The clade I and clade II mpox tends to be transmitted by close, intimate contact, skin-to-skin contact, saliva, other secretions, and so it's always been of very close contact,” Wolfe said. “I think that currently, we have found that it is spreading more than we had seen it before, for example, through sexual contact.”

And although most US providers have likely not seen patients with mpox, he says they may need to consider it in diagnosis. “Clinicians need to be aware and be looking for it, and so we can learn more about how it spread, and help prevent the spread and develop responses.”

He acknowledges there is a lot to learn about clade I. “I think we're still kind of in a learning phase for mpox,” Wolfe said. “I think there's a lot that we need to do, and get geared up to look at how it's transmitted, so we can learn about how to stop it.”

While he says it is important to give people information it is also about weighing the concern of public health and not scaring people unnecessarily. “It's always difficult to know how much to warn people and how not to create undue panic. That's something that public health professionals are always dealing with," said Wolfe. “We need to balance warning people with reducing their fear. There have not been cases of clade I in the United States, but we should have clinicians be aware.”

He does believe in active surveillance as a strategy, and says points of entry surveillance at places such as airports can help detect incoming flights from affected areas. His current company, Ginkgo Bioworks, is involved in disease surveillance including mpox.

“What we've learned from a series of outbreaks over the years, from SARS, MERS, Zika, bird flu, and the COVID pandemic is that a threat anywhere is a threat everywhere—And pathogens can spread around the world in 24 hours,” Wolfe said. “The other thing we've learned is diseases or pathogens that we typically thought might be confined to a small area [can travel]; for example, Ebola can spread globally because of the increase in worldwide travel."