Call to expedite mobilisation of resources for mpox

The Australian Global Health Alliance (AGHA) is calling on the federal government to expedite resources towards mobilisation of an effective, internationally coordinated and equitable response that will contain the mpox outbreak.

After declaring mpox a public health emergency of international concern (PHEIC), the World Health Organization recently held the first meeting of the International Health Regulations (2005) Emergency Committee. Transmitting the report of the meeting, the WHO announced a 12-month extension of the current standing recommendations for mpox and also issued temporary recommendations to prevent and control the spread.

During the first six months of 2024, the 1854 confirmed cases of mpox reported in the WHO African Region account for 36% (1854/5199) of the cases observed worldwide, according to the WHO.

In Australia, there was a total of 265 cases — Vic: 117, NSW: 105, Qld: 24, SA: 4, WA: 2, NT: 1, Tas: 0 — reported to the National Notifiable Disease Surveillance System 2024.

Wealthy countries like Australia must be both compassionate and smart, said AGHA in a statement, noting, “The first and best response for Australians is to support international efforts to limit the impact and spread of the disease where it is currently at its worst.”

The AGHA called on the government to:

1. Provide direct support to contain the response in the African region, including via direct vaccine contributions, and supporting lead multilateral agencies.
2. Support countries in our region through preparedness, prevention and early detection of mpox — ensuring they can meet obligations in the IHR through surveillance and response; and have the means to deploy vaccines, engage priority populations at risk and respond to outbreaks. The AGHA acknowledged the important work already underway in the Pacific and South-East Asia to build pandemic-resilient health systems as part of the Australian Government’s Partnerships for a Health Region initiative.
3. Support the neglected pipeline of research and development in new tools for mpox and priority pathogens with epidemic and pandemic potential, and enhance efforts to overcome bottlenecks in development and deployment of these tools globally. This is where Australian medical research can make a major contribution.
4. Rapidly mobilise cross-portfolio government advisory groups, such as the Human Animal Spillover and Emerging Disease Scanning (HASEDS) group, and engage with Australia’s Mpox Taskforce, recognising the cross-portfolio nature of the response while the new Australian CDC is still being formed. Linking departments of health and foreign affairs in all countries will also be crucial for effective response.
5. Support all measures to protect vulnerable people and prevent stigmatisation, particularly of gay, bisexual and other men who have sex with men, and migrant communities in the response.
    

WHO has not declared mpox a pandemic, rather the measures triggered by a PHEIC are designed to prevent this, reminded AGHA. The current PHEIC declaration is the second time the disease has reached this level of concern. In 2022 an outbreak occurred in Europe and spread globally, affecting 111 countries before being controlled in May 2023 through rapid mobilisation and risk reduction among gay and bisexual men.

This initial global outbreak is, however, ongoing with an uptick in 2024 and caused by a variant called clade II, predominantly affecting men who have sex with men and immunocompromised individuals,” said AGHA in a statement.

“This second PHEIC has been triggered by the emergence of a highly infectious strain last year, clade 1b, which is of high concern as it is spread more easily to close contacts and has a higher mortality rate¹. In the last six months alone, the number of reported cases has surged to 15,600 cases and 537 deaths — exceeding the total cases reported to WHO for all of last year.² This clad disproportionately affects children, with almost 70% of cases³ and 85% of recent deaths⁴ having occurred in children under the age of 15,” the statement said.

“The 2022–23 global mpox outbreak stemmed from the international community’s neglect and failure to respond swiftly and invest in equitable surveillance and research, despite regular outbreaks in Africa that eventually led to the disease’s spread to other continents.

“To prevent a repeat of history and learn from past lessons, we must act decisively to scale and coordinate our global efforts, working closely with the international global health community, including WHO and the Africa CDC, to support affected countries in containing the spread of this disease.

“Australia and the global health community must uphold the principles of equity and solidarity in making a meaningful contribution to a coordinated international response that will stamp this health emergency and prevent another pandemic. The response in the first 100 days needs to be urgent and swift as any delay to act effectively will have greater international and national costs,” AGHA concluded.
 

<sup>1. https://mailchi.mp/ipppr/jointopenletter-17387515?e=[UNIQID]
2. https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern
3. https://africacdc.org/wp-content/uploads/2024/07/MPox-Situation-in-Africa.pdf
4. https://mailchi.mp/ipppr/jointopenletter-17387515?e=[UNIQID]</sup>

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