Vaccines alone will not end the monkeypox outbreak. People at risk will also need to take action

Statement by WHO Regional Director for Europe, Dr Hans Henri P. Kluge

Copenhagen, 26 July 2022

Since the WHO Director-General has declared the escalating global monkeypox outbreak a Public Health Emergency of International Concern (EPIC), all WHO Member States, whether they have reported cases or no, they must act urgently, seizing every opportunity to anticipate, control and stop the spread of a virus from which we still have much to learn.

The outbreak initially emerged in the WHO European Region, which covers 53 countries in Europe and Central Asia, which continues to record the vast majority of cases, centered mainly among men who have sex with men. Therefore, the solutions to deal with the outbreak must also come from the Region, without stigma and discrimination towards the affected communities and in close collaboration with them.

We explain what we know and what we need to do.

Monkeypox is generally a self-limiting, non-life-threatening disease in otherwise healthy people. The disease is best known in African countries where it has been observed for decades and where deaths have occasionally been reported – five so far this year – including children and the elderly, as well as people with underlying conditions.

In the WHO European Region, the outbreak has seen the virus spread rapidly, with 37 countries and areas affected to date, with evidence of continued local transmission. From May 13 to July 22, nearly 12,000 probable or confirmed cases have been reported in the Region, mostly in men who have sex with men (MSM), of which 8% were hospitalized without, fortunately, any deaths Bye now.

Beyond the social and sexual networks of MSM, it is clear that cases in other population groups, including women and children, some of whom may be vulnerable to more serious diseases, are increasing, although they remain minimal. Sexual transmission by close contact is the key mode of spread, but cases are detected through episodes of household transmission and sometimes without a clear exposure history.

While we acknowledge the uncertainties about how this outbreak will play out, we must respond to the epidemiology in front of us by focusing on the most dominant mode of transmission, skin-to-skin contact during sexual encounters, and the groups with the most risk of infection. . As such, the responsibility to stop this outbreak is necessarily a joint responsibility, shared between health institutions and authorities, governments and affected communities, and individuals themselves.

To healthcare providers we say:

  • Remove all barriers to testing, medical care or vaccination. Any barrier, no matter how big or small, will act to prevent patients from getting closer.
  • Provide clear information on how to access care, giving patients certified medical permission for the duration of the infectious period to isolate as needed.
  • Be aware of what to look for. Case presentation may be atypical and therefore be alert to the possibility of monkeypox in the evaluation of any patient, particularly but not only men who have sex with men, and not only patients with history of travel to areas known to have monkeypox. extending
  • Remove any judgment or stigma from the patient’s path; the lessons of HIV/AIDS must not be forgotten.

To those currently at highest risk, men who have sex with men and especially those who have multiple sexual partners, we say:

  • Know the facts: We know how the disease is spreading and also what you can do to protect yourself.
  • Consider limiting your partners and sexual interactions at this time. It may be a difficult message, but being cautious can protect you and your community at large.
  • While vaccination may be available for some people at higher risk of exposure, it is not a silver bullet, and we still urge you to take steps to reduce this risk for now.
  • If you have or think you have monkey pox, you are contagious, so do everything you can to prevent the spread of the disease. Isolate yourself if you can, don’t have sex while you’re recovering, and don’t attend parties or large gatherings where there’s close contact.

To ministries of health and public health authorities, even in countries that have not yet reported a case, we say:

  • Significantly and rapidly increase national capacities for monkeypox surveillance, investigation, diagnosis and contact tracing to help identify and track all possible cases. Many cases are likely to go undetected, further fueling the outbreak.
  • Work closely with at-risk groups and communities and their leaders, including organizers of community events such as Summer Pride festivities, to develop and disseminate critical messages aimed at reducing transmission and encouraging the use of health services
  • Don’t waste valuable time and resources. Urgently find ways to address the realities of this outbreak and ensure that the response is laser-focused on stopping transmission in the groups and settings where it is or is likely to occur.

To the governments of Europe and Central Asia we say:

  • There is a growing need for interregional collaboration, based on political will, to generate evidence to support the use of vaccines and antivirals for monkeypox, as well as to target populations with risk of infection.
  • Countries must adhere to the principles of equity, helping to ensure that vaccines and antivirals reach those who need them most, rather than stockpiling supplies and “going it alone,” actions that only harm the general public good as we have seen during the response to COVID-19.

Faced with uncertainty but with a clear rationale for declaring a PHEIC, the WHO Director-General chose an approach based on no-repentance. I hope this development will help sharpen our response in Europe and Central Asia and boost investment and support in countries in Africa where the spread of the disease over the past decade has not received the international attention it needed. Increasing surveillance and response in countries where the virus is endemic helps prevent future outbreaks elsewhere.

The PHEIC statement ultimately underlines what we at WHO/Europe have been conveying since this truly extraordinary and challenging monkeypox outbreak emerged. We face this challenge across Europe and Central Asia together, putting community protection and human dignity at the heart of our regional response.


Bhanu Bhatnagar, Press Officer,

WHO/Europe Press Office,

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