The World Health Organization, for the second time in two years, has declared a viral outbreak to be a Public Health Emergency of International Concern (PHEIC). With four cases confirmed in India and around 14,500 cases globally, monkeypox outbreaks have triggered international consternation in a world that is yet to recover from the COVID-19 pandemic. After a split verdict at the International Health Regulations Emergency Committee meeting — on whether monkeypox deserves to be termed a PHEIC — it fell on WHO’s Director-General, Dr. Tedros Ghebreyesus, to take a call. A PHEIC is just one step short of a ‘pandemic’ classification. Following the declaration of COVID-19 as a pandemic on March 11, 2020, WHO had come under criticism for not responding with alacrity on the public health threat that the coronavirus pandemic portended. It had termed the COVID-19 crisis as a PHEIC on January 30, 2020 when global cases were around 7,500, or about half the levels now reported for monkeypox. The following February was the pivotal month that compelled WHO to elevate threat levels and push the world into territory that it had not navigated since the 1918 influenza pandemic. Though monkeypox is caused by a virus that is endemic in a few African countries, the world took note only after it was first reported in the U.K. on May 6, 2022. Within a month-and-a-half, it spread to 63 countries, with Spain, Belgium and the U.S — historically non-endemic for the virus — beginning to report a spike in cases. In Africa too, transmission has been historically limited and there is uncertainty over the events that have caused such a global spike.
Monkeypox, for now, has more visible manifestations such as rashes and blisters and is said to be over-represented in men who have sex with men. It is believed to spread only through close contact and is fatal only to the extremely immunocompromised. WHO has recommended that countries step up surveillance, amplify public awareness campaigns, governments work towards not stigmatising the disease, and health infrastructure be primed towards producing diagnostic kits. The experience from the COVID-19 pandemic has shown that governments implement measures to avoid ‘panic’ but are often opaque and vague with the information necessary to quell it. While it is unclear how the monkeypox outbreak will play out in the months to come, the Government must begin coordinated action with the States to accurately summarise and disseminate the extent of the threat. Until now, monkeypox fell under the category of neglected tropical diseases. Related to the eradicated smallpox virus, monkeypox is suspected to have amplified due to reduced immunity against the smallpox virus. Indian labs and biotech companies must step up research and mine their arsenal to prepare adequate defences if the need arises.
