On 23 July 2022 the Director-General of the World Health Organization (WHO) determined that the ongoing multi-country outbreak of monkeypox constitutes a Public Health Emergency of International Concern (PHEIC)[1]. The declaration was done after the Second meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox.
The World Customs Organization (WCO) has been closely monitoring recent developments regarding the current multi-country monkeypox outbreak in view of ensuring that WCO Members with public health and safety responsibilities are properly informed about the situation and are involved in national response strategies.
During the Second meeting of the monkeypox Emergency Committee, the WHO Secretariat presented the global epidemiological situation, highlighting that between 1 January 2022 and 20 July 2022, 14 533 probable and laboratory-confirmed cases have been reported to the WHO from 72 countries across all six WHO Regions; up from 3,040 cases in 47 countries at the beginning of May 2022. The WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions, except in the European region where the risk is assessed as high. As per the WHO, there is also a clear risk of further international spread, although the risk of interference with international traffic remains low for the moment.
The WHO Director-General also issued a set of temporary recommendations that apply to different groups of Members, based on their epidemiological situation, patterns of transmission and capacities. Two recommendations concerning international travel are addressed to the group of Members that are experiencing human-to-human transmission of the monkeypox virus, including the availability of recently imported cases of monkeypox in the human population. As per the first recommendation, any individual with symptoms compatible with monkeypox virus infection or an individual that is subject to health monitoring with regard to monkeypox should avoid undertaking any travel, including international. Cross-border workers, who are identified as contacts of a monkeypox case, and, hence, under health monitoring, can continue their routine daily activities provided that health monitoring is duly coordinated by the health authorities from both/all sides of the border. The second recommendation with regard to international travel concerns the establishment of operational channels between health authorities, transportation authorities, and operators of conveyances and points of entry to facilitate international contact tracing and to provide relevant communication materials at points of entry.
Apart from those two recommendations, the WHO advises against any additional general or targeted international travel-related measures.
With regard to vaccines and medicines, the WHO recommends to Members that have manufacturing capacity for smallpox and monkeypox diagnostics, vaccines or therapeutics to raise production and availability of medical countermeasures. Members and manufacturers should work with the WHO to ensure diagnostics, vaccines, therapeutics, and other necessary supplies are made available based on public health needs, solidarity and at reasonable cost to countries where they are most needed to support efforts to stop the onward spread of monkeypox.
At the level of borders, many WCO Members play an important role in national response strategies to mitigate epidemic-related public health and safety risks. In this context, it is of utmost importance that Customs administrations with health and safety responsibilities are adequately integrated as part of the preparedness and preresponse mechanisms.
Moreover, Customs have a key role to play in facilitating and securing the cross-border movement of situationally critical medicines and vaccines and Members should duly implement the measures outlined in the December 2020 Resolution of the Council in that regard.
The WCO will keep a close watch on the multi-country monkeypox outbreak and any associated travel- and trade-related developments.
[1] The term PHEIC is defined in the IHR as “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response”.