The World Health Organization (WHO) convened the second meeting of the International Health Regulations Emergency Committee on November 22, 2024, to assess the upsurge of mpox cases globally and its continued designation as a Public Health Emergency of International Concern (PHEIC).

Key Observations:

1. Epidemiological Status:
   • Mpox cases have risen globally, with ongoing geographic spread, particularly of clade Ib in the WHO African Region.
   • Clade Ib transmission hotspots: Democratic Republic of the Congo (DRC), Burundi, Uganda, Kenya, and Rwanda.
   • Mpox cases linked to African outbreaks have been detected in other regions, including the Americas, Europe, and South-East Asia.
   • Transmission dynamics have evolved, spreading from sexual networks to households and broader communities.
2. Mortality and Risk Assessment:
   • Clade Ib poses high public health and international spread risks.
   • Case fatality rates are higher in children under five, especially in rural endemic areas.
3. Response Challenges:
   • Suboptimal implementation of testing, isolation, contact tracing, and vaccination strategies.
   • Insufficient local and national data to optimize interventions.
   • Limited vaccination coverage in affected regions, with challenges in addressing vaccine hesitancy and regulatory barriers.
4. Coordination and Resource Gaps:
   • Collaborative efforts by WHO and Africa CDC have scaled up response mechanisms, including vaccine distribution through the Access and Allocation Mechanism (AAM).
   • Funding shortfalls remain, with only $40.6 million of the required $87.4 million secured.

Committee Recommendations:

The Committee reaffirmed that the mpox upsurge continues to meet the criteria for a PHEIC. Temporary recommendations focus on:

• Strengthening local surveillance and data collection.
• Enhancing equitable vaccine access and targeted vaccination efforts in transmission hotspots.
• Increasing public health communication to combat vaccine hesitancy.
• Encouraging integrated, localized responses rather than broad geographic measures.
• Expanding research on vaccine efficacy and predictive modeling for MPXV spread.

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Next Steps:

WHO and Africa CDC will continue to align strategies under the Mpox Continental Preparedness and Response Plan. Member States are urged to enhance political commitment and allocate resources to address mpox effectively while balancing concurrent health emergencies.

This meeting underscores the necessity for a sustained, cohesive global response to mitigate mpox transmission and its public health impact.

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