The fourth meeting of the International Health Regulations (2005) (IHR) Emergency Committee on the multi-nation monkeypox outbreak (mpox), held on February 9, 2023, from 12:00 to 17:00 CET, is reported by the WHO Director-General.
Following numerous discussions with international specialists, WHO suggests the new preferred name “mpox” as an English equivalent to monkeypox. For a year, both titles will be used interchangeably as the word “monkeypox” is phased out. The term “mpox” is used in English in this paper.
The Emergency Committee recognized that the number of reported cases has continued to drop since its previous meeting and that the worldwide response to the multi-country mpox outbreak has improved.
The Committee noted that a small number of nations continues to experience a persistent prevalence of disease, and it also believes that under-reporting of illness detection and confirmed cases in other regions is possible. As a result, the Committee examined a number of options for maintaining focus and funding to contain the outbreak and recommended maintaining the Public Health Emergency of International Concern (PHEIC) while beginning to think about plans to incorporate measles prevention, preparedness, and response within national surveillance and control programmes, including for HIV and other sexually transmissible infections.
The WHO Director-General thanks the Chair, Members, and Advisers for their advice and agrees that the event still qualifies as a PHEIC for the reasons listed in the meeting’s proceedings below. He then issues updated Temporary Recommendations regarding this PHEIC, which are displayed at the end of this document. The IHR Emergency Committee’s fourth meeting on the multi-nation mpox outbreak was held via videoconference, with the Chair and Vice-Chair physically present on the grounds of the WHO headquarters in Geneva, Switzerland. Four of the Committee’s nine Advisers and thirteen of its fifteen members attended the meeting.
The WHO Director-General welcomed the Committee in his opening remarks and observed a consistent drop in cases worldwide, with the majority of cases coming from the Regions of the Americas. The Director-General also made note of the necessity of maintaining efforts for surveillance, prevention, and care; immunizing high-risk populations; enhancing equitable access to diagnostics, vaccines, and treatment for all; continuing the fight against stigma and discrimination; and guaranteeing the respect for human rights. He came to the conclusion that over the long term, mpox programs and services should be integrated into national surveillance and control programmes, including for HIV and other sexually transmitted infections, while acknowledging that continued human-to-human transmission may cause a resurgence of cases.
The Committee Members and Advisors were briefed by the Office of Legal Counsel’s representative on their duties and authority under the pertinent IHR articles. The Department of Compliance, Risk Management, and Ethics’ Ethics Officer reminded Members and Advisers of their obligation to maintain the secrecy of Committee discussions and deliberations as well as their personal obligation to promptly disclose to WHO any interests of a personal, professional, financial, intellectual, or commercial nature that might give rise to a perceived or actual conflict of interest.
The meeting was officially opened by Dr. Jean-Marie Okwo-Bele, Chair of the Emergency Committee, who also gave a brief overview of its goals: to discuss whether the multi-country mpox outbreak still qualifies as a PHEIC with the WHO Director-General and, if so, to review the proposed Temporary Recommendations to States Parties.
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