Emergency Situation: How to Handle a Potential “Monkeypox” Pandemic?
The monkeypox virus has become a significant challenge for many countries, especially after the World Health Organization (WHO) declared monkeypox a global health emergency. This declaration followed its spread in several neighboring and non-neighboring countries of the Democratic Republic of Congo, the current epicenter of the virus. Additionally, the African Union’s health authority has classified monkeypox as a public health emergency due to its widespread outbreak in several African countries, raising concerns that the world could face a new pandemic in 2024, potentially reminiscent of the COVID-19 scenario.
Indicators of the Threat
The monkeypox virus has undergone several significant developments, making it a current global threat. These developments can be summarized as follows:
Continued Spread of the Virus in African Countries: Monkeypox, now known as “Mpox,” was first discovered in 1985 when it spread in a research monkey colony in Denmark. However, the first recorded human transmission occurred in 1970 when a 9-month-old infant showed symptoms. The virus’s spread among humans was initially limited to the Democratic Republic of Congo and a few neighboring African countries, with Nigeria, for instance, recording hundreds of cases in 2007. In May 2022, non-African countries reported monkeypox cases. By July of that year, WHO declared the outbreak a global health emergency—the highest medical alert that WHO can issue—for the first time. Within just one year, over 10 countries recorded nearly 90,000 monkeypox cases and more than 150 deaths. Despite this, WHO lifted the global emergency status for this virus in May 2023, as it no longer considered it a global health emergency, despite its continued spread in some countries, albeit at very limited rates.
Widening Geographic Spread of the Virus: Monkeypox is no longer confined to a few African countries but has become more widespread geographically. Infection rates in the Democratic Republic of Congo and several other countries began to rise again in early 2024. A WHO report in June 2024 documented 175 cases across North, Central, and South America, along with 100 cases in Europe and only 11 cases in Southeast Asia. The virus spread more significantly among individuals in the Democratic Republic of Congo (the epicenter of the virus), with local reports in May 2024 documenting 7,851 monkeypox cases and 384 deaths.
Increasing Warnings from International Organizations about the Virus: Recently, there have been growing warnings from international organizations about the virus’s dangers. All these developments prompted the African Union’s health authority to classify the virus as a public health emergency on August 13, 2024. The authority warned of the virus’s spread across the African continent, including densely populated areas, and not just in remote and rural regions as was previously the case. WHO quickly joined the list of institutions warning about the virus’s spread. On August 14, 2024, WHO declared monkeypox a global health emergency for the second time in its history. A day after WHO’s announcement, Sweden reported a case of monkeypox within its borders, marking the first case outside Central and East Africa this year.
The Danger of the Virus’s Genetic Mutations: WHO has identified two major variants responsible for the spread of monkeypox. The first strain, “Clade I,” spread significantly in the Democratic Republic of Congo and has more severe and deadly symptoms than the second strain, “Clade II,” which spread to more than 100 countries in 2022 and prompted the first emergency declaration related to the virus. However, global health authorities have confirmed that a development related to the first strain, dubbed “Clade Ib,” is largely responsible for the recent spike in infections. The first case of this variant was recorded in the Democratic Republic of Congo in April 2024, with confirmed cases in Uganda, Burundi, Rwanda, and Kenya. This variant has also been linked to the case reported in Sweden in August 2024.
Future Challenges
Despite many countries raising their health alert levels to respond to the virus, some experts downplay its severity, suggesting that the coronavirus experience will not be repeated with the current virus. In general, the likelihood of monkeypox becoming a global pandemic similar to COVID-19 depends on several key factors, including:
Continued Spread of the Virus Outside Traditional African Hotspots: Some experts believe that the declarations of emergency by various international and local health authorities reflect deep concern among scientists that the monkeypox outbreak could evolve into an epidemic that spreads across Africa and beyond at an accelerated rate, potentially turning into a global and catastrophic health pandemic similar to the coronavirus pandemic.
Difficulty in Predicting the Virus’s Genetic Evolution: Despite monkeypox’s long presence on the global stage, many unknowns remain about how the virus spreads and why it suddenly became widespread worldwide in 2022, then receded in 2023, only to resurge with higher rates in the current period. This includes its mutations and genetic developments. Although most genetic mutations have no effect, some have made the virus more lethal and transmissible. When geneticists compared the monkeypox genome from 2022 to a sample collected in 2017, they found around 40 genetic mutations. Some researchers have suggested that these mutations may have made the virus easier to spread from person to person, but there seems to be no strong consensus yet.
Rate of Virus Spread: The speed of the virus’s spread is an important factor in whether it becomes a global pandemic similar to the coronavirus pandemic. In this regard, a report by Asharq Al-Awsat newspaper indicates that monkeypox spreads very slowly compared to the coronavirus. Shortly after COVID-19 was identified in China, the number of cases jumped sharply from several hundred to several thousand in one week in January 2020, and the number of cases increased more than tenfold. By March 2020, when WHO described COVID-19 as a pandemic, there were over 126,000 infections and 4,600 deaths about three months after the coronavirus was first identified. However, unlike COVID-19, it took from 2022 until monkeypox cases reached nearly 100,000 worldwide, according to WHO.
Health Systems’ Ability to Handle the Virus: Global health systems are suffering from a significant decline in their capacities, especially with the pressures imposed by the coronavirus pandemic on these institutions, alongside crises related to the shortage of healthcare workers and general cuts in health funding. These problems are particularly prominent in several African countries that are the centers of the virus’s spread. Acknowledging this shortfall, the African Union announced the allocation of $10.4 million in funds to respond to monkeypox, while WHO promised to provide $1.45 million from emergency funds to combat the virus.
Availability of Effective Vaccines to Combat the Virus: Some vaccines used to prevent smallpox help in combating the monkeypox epidemic. For example, the “Jynneos” vaccine, produced by the Danish company Bavarian Nordic, was used in some monkeypox prevention campaigns in Europe and America after a case was detected in 2022. Additionally, the “LC16” vaccine, produced by the Japanese company KM Biologics, has also been used. However, the real crisis lies in the weak industrial infrastructure in the countries currently at the center of the virus’s spread, such as the Democratic Republic of Congo, and their lack of millions of dollars to import such drugs from abroad.
Limits of Support from Developed Countries to African Countries Struggling with the Virus: As mentioned earlier, African countries facing the virus outbreak face enormous challenges in dealing with it. For example, Democratic Republic of Congo’s Health Minister Roger Kamba mentioned that his country needs 3.5 million doses of monkeypox vaccines to stop the outbreak. He added, “This is why it is important to ask the international community to act and say: Let us provide assistance, let us provide resources so that we can access these vaccines.” In this context, some European countries and the United States have initiated technical and financial support to respond to the monkeypox outbreak in Africa. During the second week of August, the United States Agency for International Development (USAID) announced that it would allocate $10 million in funds to support the monkeypox response in the Democratic Republic of Congo.
Conclusion
These concerning developments regarding the monkeypox virus confirm that global health will always be a source of concern, dismissing the possibility of the international community ignoring it in favor of addressing other more pressing international issues at the moment, such as the conflict in the Middle East, the Russia-Ukraine war, and the competition between the United States and China.
