The World Health Organization (WHO) has activated its highest alert level for the growing monkeypox outbreak, declaring the virus a public health emergency of international concern.

The rare designation means the WHO now views the outbreak as a significant enough threat to global health that a coordinated international response is needed to prevent the virus from spreading further and potentially escalating into a pandemic.

Although the declaration does not impose requirements on national governments, it serves as an urgent call for action.  The WHO can only issue guidance and recommendations to its member states, not mandates.  Member states are required to report events that pose a threat to global health.

The U.N. agency last month declined to declare a global emergency in response to monkeypox. But infections have increased substantially over the past several weeks, pushing WHO Director General Tedros Adhanom Ghebreyesus to issue the highest alert on July 23.

Media reports say that before a global health emergency is declared, the WHO’s emergency committee has met to weigh the evidence and make a recommendation to the director general.  The committee was reportedly  unable to reach a consensus on whether monkeypox constitutes an emergency.  However, Mr. Tedros Adhanom Ghebreyesus, as the WHO’s chief, made the decision to issue the highest alert based on the rapid spread of the outbreak around the world.

A Public Health Emergency of International Concern is declared when an “extraordinary event” arises that is “serious, sudden, unusual, or unexpected,” and “may require immediate international action,” WHO explains.

Environment News Service (ENS) reported on July 24 that more than 14,500 cases of monkeypox in 72 countries that are Members of the World Health Organization have been reported to the organization this year.

“We have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little,” Tedros said. “For all of these reasons, I have decided that the global monkeypox outbreak represents a public health emergency of international concern.”

Meanwhile, CNBC reported on July 23 that more than 16,000 cases of monkeypox have been reported across more than 70 countries so far this year, and the number of confirmed infections rose 77% from late June through early July, according to WHO data. Men who have sex with men are currently at highest risk of infection.

Five deaths from the virus have been reported in Africa this year.  No deaths have been reported outside Africa so far.

Citing the U.S. Centers for Disease Control and Prevention, CNBC says most people are recovering from monkeypox in two to four weeks.  

The current monkeypox outbreak is reportedly highly unusual because it is spreading widely in North American and European nations where the virus is not usually found.  Historically, monkeypox has spread at low levels in remote parts of West and Central Africa where rodents and other animals carried the virus.

Europe is currently the global epicenter of the outbreak, reporting more than 80% of confirmed infections worldwide in 2022.  The U.S. has reported more than 2,500 monkeypox cases so far across 44 states, Washington, D.C., and Puerto Rico, according to CNBC.

Dr. Tedros said the risk posed by monkeypox is moderate globally, but the threat is high in Europe. There’s clearly a risk that the virus will continue to spread around the world, he said, though it’s unlikely to disrupt global trade or travel right now.

Tajik health officials say no cases of monkeypox have been registered in Tajikistan so far.