SINGAPORE: On Aug 14, the World Health Organization (WHO) declared mpox a global public health emergency, its highest level of alert. The next day, Sweden announced the first case of clade 1b outside of Africa. On Thursday (Aug 22)sigeplay, it was Thailand’s turn to confirm Asia’s first known case of the new, deadlier strain.
The world is on the alert for the virus to spread more widely, with countries like Singapore, Malaysia, and Indonesia stepping up precautionary border screening measures.
The global public health machinery has sprung into action. But considering this is the second time in just over two years that mpox has been declared a Public Health Emergency of International Concern (PHEIC), it’s fair to ask: Have we learnt the lessons from the first mpox emergency or even COVID-19?
Mpox is certainly not the new COVID-19. But the lessons remain relevant.
TO DECLARE OR NOT TO DECLARE A GLOBAL EMERGENCYIt’s impossible for WHO to please everyone when it comes to deciding whether to declare a PHEIC and when to declare one.
Such declarations are formal calls to action, aimed at mobilising resources and coordinating global efforts to eliminate or mitigate the specific emergency. Call it too late and the world loses precious time helping people prevent exposure, infection and even death. Call it too early and it can be perceived as an overreaction or fearmongering.
Although the term “pandemic” is more easily understood, it lacks universally agreed-upon definitions and carries no legal obligations. Once a PHEIC is declared, WHO member states are legally obligated to cooperate internationally, share information and implement recommended measures under the International Health Regulations (IHR).
On this, it is clear that WHO has learnt its lesson from the 2022 mpox emergency.
The first mpox PHEIC was declared on Jul 23, 2022, weeks after clusters of clade 2 mpox were first reported outside Africa in May that year.
The WHO had been roundly criticised for the delay: The perception was that a PHEIC was declared only after the virus had spread to Western countries, even though a sustained outbreak of this virus strain has been growing in Nigeria since 2017 and spreading to neighbouring African countries without attracting much international attention or aid.
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Commentary: Singapore’s pandemic lesson is also about knowing when to shift away from old playbook 
Commentary: Omicron shows why we need to get low-income countries vaccinated This time, facing a deadlier clade, WHO declared a global emergency at a much earlier stage while cases were still mostly concentrated in Africa. Increased vigilance is already paying off - that countries outside of Africa reported their first cases soon after the declaration should be seen in this positive light, as these could have otherwise spread undetected.
Resources are also being rapidly secured to mitigate the outbreak at source. Within a day of the PHEIC declaration, Bavarian Nordic – the company that developed the only vaccine widely approved for use against mpox today – had declared that it was ready to supply up to 10 million doses of its vaccine by 2025. The International Federation of Red Cross and Red Crescent Societies as well as other regional and global institutions have also ramped up response efforts.
Coordination of global response is still an issue. But there is now a greater likelihood of preventing an outbreak on the same scale as the 2022 mpox emergency – over 87,000 confirmed cases across 111 countries and territories, according to a WHO situation report after the PHEIC was lifted in May 2023.
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CNA Explains: Deadlier and more contagious – how dangerous is the new mpox variant? MPOX IS NOT THE NEXT COVID-19Even if mpox is a completely different disease from COVID-19 and is not a novel virus, one crucial lesson stands: The need for international cooperation and timely information sharing.
The world needs to understand the new clade 1b mpox virus, track its spread and coordinate an effective response. Effectiveness includes considerations of equity – to ensure that public health messagessigeplay, education and interventions including diagnostics and vaccines reach those who are most at risk.
A shipment of COVID-19 vaccines distributed by the COVAX Facility arrives in Abidjan, Ivory Coast, on Friday, Feb 25, 2021. (Photo: AP/Diomande Ble Blonde)