• The World Health Organisation (WHO) launched a global Strategic Preparedness and Response Plan to stop outbreaks of human-to-human transmission of mpox through coordinated global, regional, and national efforts. 

• This follows the declaration of a public health emergency of international concern by the WHO Director-General on August 14.

• The plan covers the six-month period of September 2024-February 2025, envisioning a $135 million funding need for the response by WHO, Member States, partners including Africa Centres for Disease Control and Prevention (Africa CDC), communities, and researchers, among others.

Mpox Global Strategic Preparedness and Response Plan (SPRP)

• The global mpox outbreak, which began in 2022, has resulted in over one lakh confirmed cases reported to the WHO. 

• The rapid spread of the new Clade 1b strain, particularly in eastern Democratic Republic of the Congo and neighboring countries, and its recent detection in Sweden and Thailand, underscores the growing threat. 

• Other clades, such as Clade 1a and Clade 2, are also spreading in various African countries, complicating the response.

• The Strategic Preparedness and Response Plan provides a comprehensive framework for public health preparedness and response at global, regional, and national levels. 

• Covering the period from September 2024 to February 2025, the plan outlines urgent actions to halt the spread of Clade 1b in eastern DRC and neighboring countries, as well as to control outbreaks of Clades 1 and 2 in endemic regions of the DRC, Nigeria, and other African countries.

• The SPRP emphasizes the need for enhanced surveillance, timely detection, and rapid response, particularly in high-risk areas. 

It focuses on:

i) Implementing comprehensive surveillance, prevention, readiness and response strategies.

ii) Advancing research and equitable access to medical countermeasures like diagnostic tests and vaccines.

iii) Minimising animal-to-human transmission.

iv) Empowering communities to actively participate in outbreak prevention and control.

• Strategic vaccination efforts will focus on individuals at the highest risk, including close contacts of recent cases and healthcare workers, to interrupt transmission chains. 

• The plan also calls for global cooperation to increase vaccine access, particularly in low and middle-income countries, while advancing research and ensuring equitable access to diagnostics, therapeutics, and other

essential health products. 

• Guided by the principles of global solidarity, equity, and community empowerment, the SPRP highlights the importance of harmonised strategies, collaborative decision-making, and transparent information sharing.

• At the national and sub-national level, health authorities will adapt strategies in response to current epidemiological trends.

• The initial six-month operation will focus on controlling acute outbreaks of human-to-human transmission, with an estimated budget of $135 million for international support to national mpox responses. This budget excludes the cost of procuring approximately two million vaccine doses.

What is mpox?

• Mpox (monkeypox) is an infectious disease caused by the monkeypox virus (MPXV). 

• Mpox virus belongs to the Orthopoxvirus genus in the family Poxviridae. The Orthopoxvirus genus also includes variola virus (which causes smallpox), vaccinia virus (used in the smallpox vaccine), and cowpox virus.

• Mpox has symptoms similar, but less severe, to smallpox. While smallpox was eradicated in 1980, mpox continues to occur in countries of central and west Africa.

• Mpox is zoonosis: a disease that is transmitted from animals to humans.

• Mpox was formerly called monkeypox. Following a series of consultations with global experts, WHO began using “mpox” as a synonym for monkeypox. 

• Monkeypox was first discovered in 1958 when outbreaks of a pox-like disease occurred in monkeys kept for research, hence the name ‘monkeypox’.

• The first human case was recorded in 1970 in the Democratic Republic of the Congo (then known as Zaire), and since then the infection has been reported in a number of central and western African countries. Most cases are reported from Congo and Nigeria. 

• In 2003, monkeypox was recorded in the United States when an outbreak occurred following importation of rodents from Africa. Cases were reported in both humans and pet prairie dogs. All the human infections followed contact with an infected pet and all patients recovered. 

• Mpox is endemic in densely forested regions of West, Central and East Africa, particularly in the northern and central regions of Congo. 

• Mpox outbreaks are caused by different viruses called clades. Clade 1 has been circulating in Congo for years, while clade 2 was responsible for the global outbreak which began in 2022.

Transmission

• Mpox does not spread easily between people.

• Spread of mpox may occur when a person comes into close contact with an animal (rodents are believed to be the primary animal reservoir for transmission to humans), human, or materials contaminated with the virus. 

• The virus enters the body through broken skin (even if not visible), the respiratory tract, or the mucous membranes (eyes, nose, or mouth).

Person-to-person spread is very uncommon, but may occur through:

• Contact with clothing or linens (such as bedding or towels) used by an infected person.

• Direct contact with mpox skin lesions or scabs.

• Coughing or sneezing of an individual with a mpox rash.

Symptoms

Initial symptoms include fever, headache, muscle aches, backache, swollen lymph nodes, chills and exhaustion. A rash can develop, often beginning on the face, then spreading to other parts of the body. The rash changes and goes through different stages before finally forming a scab, which later falls off.

Treatment

• Detection of viral DNA by polymerase chain reaction (PCR) is the preferred laboratory test for mpox. 

• Mpox, in most cases, is a mild condition which will resolve on its own and have no long-term effects on a person’s health. Most people recover within a few weeks. However, severe illness can occur in some individuals.

• Treatment of mpox patients is supportive dependent on the symptoms. Various compounds that may be effective against mpox virus infection are being developed and tested.

• Prevention and control of human mpox rely on raising awareness in communities and educating health workers to prevent infection and stop transmission.

• Currently, two mpox vaccines have been approved by WHO-listed national regulatory authorities, and which its expert group on immunisations have also recommended.