A World Health Organization committee of experts met Thursday to decide whether the monkeypox outbreak which has seen a surge of cases around the world constitutes a global health emergency.
The outcome of the private meeting will be issued on Friday at the earliest, the WHO said.
A surge of monkeypox cases has been detected since May outside of the West and Central African countries where the disease has long been endemic. Most of the new cases have been in Western Europe.
More than 3,200 confirmed cases and one death have now been reported to the WHO from 48 countries in total this year, WHO chief Tedros Adhanom Ghebreyesus told the start of the meeting.
Tedros announced on June 14 that he would convene an emergency committee to assess whether the outbreak constitutes a public health emergency of international concern (PHEIC) – the highest alarm that the United Nations health agency can sound.
Besides providing a PHEIC assessment, the committee members were set to give the WHO and its member states advice on how to better prevent the spread of the disease and manage their response.
Transmission fears
Tedros told Thursday's meeting that all countries needed to strengthen their capacities to prevent onward transmission of monkeypox, using surveillance, contact-tracing and isolating infected patients.
"The outbreak in newly-affected countries continues to be primarily among men who have sex with men, and who have reported recent sex with new or multiple partners," he said, via video link from the Commonwealth summit in the Rwandan capital Kigali.
"Person-to-person transmission is ongoing and is likely underestimated."
He said that in addition to the 3,200-plus confirmed cases, almost 1,500 suspected cases of monkeypox and around 70 suspected deaths have been reported in central Africa this year.
The emergency committee will provide Tedros with a PHEIC recommendation, and an assessment of the risk to human health, the risk of international spread and the risk of interference with international traffic.
Tedros will then make the final determination on whether a PHEIC should be declared, based on their advice.
There have been six PHEIC declarations since 2009, the last being for COVID-19 in 2020 – though the sluggish global response to the alarm bell still rankles at the WHO's Geneva headquarters.
A PHEIC was declared after a third emergency committee meeting on Jan. 30. But it was only after March 11, when Tedros described the rapidly-worsening situation as a pandemic, that many countries seemed to wake up to the danger.
Testing troubles
On the number of cases, "it is a little difficult to see how much of this is the tip of the iceberg," said Philippe Duneton, head of the Unitaid agency, which invests in ways to prevent, diagnose and treat diseases.
"There are no easy-to-use tests to detect it. This is essentially done at the clinical level. So an important issue is to have testing which is done earlier and which makes it possible to detect cases, particularly among case contacts," he told Agence France-Presse (AFP).
The normal initial symptoms of monkeypox include a high fever, swollen lymph nodes and a blistery chickenpox-like rash.
The WHO's 16-member emergency committee on monkeypox is chaired by Jean-Marie Okwo-Bele from the Democratic Republic of Congo, who is a former director of the WHO's Vaccines and Immunisation Department.
It is co-chaired by Nicola Low, an associate professor of epidemiology and public health medicine from Bern University.
The other 14 members are from institutions in Brazil, Britain, Japan, Morocco, Nigeria, Russia, Senegal, Switzerland, Thailand and the United States.
Eight advisers from Canada, the Democratic Republic of Congo, South Africa, Sweden, Switzerland and the United States also took part in Thursday's hybrid meeting.