Smallpox, also known as monkeypox, has once again constituted a Public Health Emergency of International Concern (PHEIC). This was announced by WHO Director-General Tedros Adhanom Ghebreyesus at the end of a long meeting of the Emergency Committee called to analyze the risks associated with the epidemic that began in recent months in the Democratic Republic of the Congo.

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“Today the Emergency Committee met and informed me that the situation constitutes a public health emergency of international concern. I have accepted that advice,” Tedros said. Yesterday, the Africa CDC declared a continental emergency.
Tedros explained that the concern is linked to at least two factors. First, the scale of the epidemic, which recorded more than 14,000 cases and 524 deaths in the Democratic Republic of the Congo alone in the first half of the year, which is already more than the toll for the whole of 2023.
Added to this is the “discovery and rapid spread of a new biological branch.” [ceppo, n.d.r..] Tedros said smallpox in eastern DRC, its detection in neighbouring countries that had not previously reported the disease, and the risk of its spread to Africa and beyond.
Over the past month, nearly 90 cases of smallpox strain 1b have been reported in four neighboring countries that had not previously reported the disease: Burundi, Kenya, Rwanda and Uganda.

In the background, there are various outbreaks due to other strains in Africa and outside the continent, hence the decision to declare a public health emergency, “the highest level of alert under international health legislation,” as Tedros put it. Previously, he had only been declared infected with swine flu in 2009, polio (2014), Ebola (in 2013 and again in 2019), Zika (2016), Covid (2020), and the previous smallpox outbreak in 2022.

Meanwhile, the response to the pandemic has already begun. The World Health Organization has announced that it has developed a response plan that requires an initial investment of $15 million. The World Health Organization has already allocated $1.45 million, and more resources will be allocated in the coming days; contributions from other donors are also expected.
Europe was the first to act. The European Health Emergency Preparedness and Response Agency (HERA) announced yesterday that it had purchased 175,000 doses of smallpox vaccine to donate to African countries.
Another 40,000 doses will be donated by the manufacturer Bavarian Nordic. The vaccines will be distributed by the Africa CDC, while HERA will donate 3.5 million euros by early autumn to boost virus testing and sequencing capacity in the region. As for vaccines, the problem at the moment seems to be whether the countries most affected by the pandemic can obtain them. Tim Nguyen, head of the WHO's High Impact Event Preparedness Section, said that around 500,000 doses of Bavarian Nordic's MVA-BN vaccine could already be available from the manufacturer and that another 2.4 million doses could be produced by the end of the year. Unit. “In 2025, another 10 million doses could be produced,” Nguyen added. “We can add to these doses that several countries have already allocated and can donate if other countries need them.”

For the second vaccine, LC-16, a product that “has not been commercialized but is currently being produced on behalf of the Japanese government,” Nguyen explained that in the previous pandemic, “Japan was very generous and donated vaccines to countries” that needed it. “We are working to facilitate the donation of LC-16 reserves,” Nguyen added.

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