A coalition of civil society organisations has criticised the World Health Organisation's declaration of Mpox as a public health emergency of international concern (PHEIC).
Edet Williams, a member of the coalition under the auspices of Equity International Initiative, spoke on Monday during a press conference in Ikeja, Lagos. The press conference was themed “The WHO Declaration on MPOX as a Global Health Crisis: A Civil Society Response.”
Mpox is a rare viral zoonotic infectious disease, highly prevalent in Africa.
Nigeria has recorded 40 confirmed and 830 suspected cases of Mpox across 33 states, including the FCT.
No deaths from Mpox, formerly called monkeypox, have been recorded in Nigeria.
In Africa, more than 18,000 cases have been reported in 12 countries, with more than 3,000 confirmed. More than 500 deaths have been recorded.
On 14 August, WHO Director-General Tedros Ghebreyesus said that the rise in Mpox cases in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR).
Article page with promotion of financial support
Mr Ghebreyesus' statement came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data submitted by WHO experts and affected countries.
WHO Director-General Tedros Adhanom Ghebreyesus [Photo: Scrol.in]The committee considered that the increase in Mpox cases constitutes a PHEIC, with the potential to spread to other countries in Africa and possibly beyond the continent.
In addition, Mpox was declared a PHEIC in May 2020.
Low mortality rate
“Throughout 2023, we had a total of 98 confirmed cases of monkeypox… with two deaths in a country of 200 million people,” said Williams, head of the Elite Medical Team.
He added: “Monkeypox is not new. We have two clades: one clade II is self-limiting (this means you get it on Monday; if you do nothing until next Tuesday, it goes away), and the most you get is rashes, fever and headaches. Recently, we have had clade I and (subclade) Ib, which is now the concern and even in the clade, it is potentially fatal for those who have it.
“We have it in the Democratic Republic of Congo, which is the most endemic. The maximum mortality rate is 3.5 percent.
“Globally, we have a mortality rate of about 3.2 percent. It’s a little bit difficult to understand why this has become a major emergency that we need to look at.”
Meanwhile, according to WHO, 5,940 cases of Mpox have been reported in Africa, with a total of 48 deaths between January 2022 and 18 August. Globally, 102,997 cases with 223 deaths have been reported from 1 January 2022 to 31 July.
Conditions for declaring a public health emergency
Under WHO standards, Mr Williams said certain conditions must be met before Mpox can be declared a public emergency of international concern.
“Is the impact on public health serious? In terms of severity for morbidity and mortality, is it an unusual or unexpected event?” he asked.
He noted that the current response mechanism needs to be reviewed.
He said that in the past, public health education and surveillance were used to successfully combat the Mpox outbreak.
“So why are we here now choosing another route that is going to cost us much more in a country that is suffering from a lack of finances?”
Obielumani Ideh of Doctors' Health Initiative also reiterated that Mpox does not meet the criteria for PHEIC status.
To be classified as a PHEIC, it must be “serious, sudden, unusual or unexpected; have public health implications beyond the national border of the affected state and may require immediate international action.”
He said that before the introduction of vaccine treatment, Mpox was being addressed locally through public awareness, avoiding close contact with infected people or contaminated materials and using gloves and other personal protective clothing while caring for the sick.
Ms Ideh also noted that Mpox is less severe than smallpox.
He added that of the two clade I and II variants of Mpox, only the clade I virus is spreading in the Democratic Republic of the Congo, while the clade II variant is found mainly in West Africa.
Other members of the group include Segun Adebayo, Deputy Director of the Centre for Food Security and Agricultural Research, Patrick Ijewere and Gold Boms.