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Monkeypox or Moneypox?

Tedros overrules his panel and declares Monkeypox a Public Health Emergency of International Concern

In a move that is sure to trigger widespread discussion concerning the independence, objectivity and wisdom of granting authority to the WHO to manage global infectious diseases responses, the monkeypox outbreak has been declared a Public Health Emergency of International Concern (PHEIC) by the World Health Organization. The declaration was made unilaterally, in direct contradiction of independent review panel advice, by WHO director Tedros Adhanom Ghebreyesus. Tedros made the declaration despite a lack of consensus among members of the WHO’s emergency committee on the monkeypox outbreak, and in so doing overruled his own review panel, who had voted 9 against, 6 for declaring the PHEIC. Tedros asserted that this committee of experts (who met on Thursday) was unable to reach a consensus, so it fell on him to decide whether to trigger the highest alert possible. Any objective outside observer would conclude that the committee failed to endorse moving to a PHEIC. When a similar meeting was previously held on June 23, 2022, the committee resolved by consensus to advise the WHO Director-General that at this stage the outbreak should be determined to not constitute a PHEIC. An official United Nations article summarizing this can be found here. When the group met in June, the breakdown was 11 against and three for. It is not clear what has changed in the intervening four weeks to justify the change in Tedros’ position, although comments from internet pundits raise concerns that the unilateral action was taken in response to pressure from special interest advocacy groups.

There has also been a sudden burst of coordinated social media postings raising concerns regarding Monkeypox risks to children, which raises the question “If Monkeypox is a sexually transmitted disease, why are kids getting it?”

On Friday, the U.S. confirmed the first two cases of monkeypox in children, Centers for Disease Control Prevention and Control (CDC) Director Rochelle Walensky said Friday. The CDC has said children, especially those under 8 years old, are among those at “especially increased risk” for severe monkeypox disease.

At a virtual event with the Washington Post on Friday focused on new coronavirus variants, Walensky stated that:

“Both of those children are traced back to individuals who come from the men-who-have-sex-with-men community, the gay men’s community,”

Clearly, the WHO committee did not reach the desired decision to declare a PHEIC, and so for some extraordinary reason Tedros stepped in.

Though the committee does not formally vote, a survey of the members revealed that nine thought a PHEIC should not be declared and six supported a declaration. “Nine and six is very, very close,” Tedros said in a news conference called to announce the decision. “Since the role of the committee is to advise, I then had to act as a tie-breaker.”

Tedros made the declaration despite a lack of consensus among members of the WHO’s emergency committee on the monkeypox outbreak. It’s the first time a leader of a UN health agency has made such a decision unilaterally.

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