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There has been an increase in the number of people infected with monkeypox virus (MPXV) clade I in the Democratic Republic of the Congo (DRC) since November 2023.

The Director-General of the World Health Organization (WHO), having concurred with the advice offered by the International Health Regulations (2005) (IHR or Regulations) Emergency Committee regarding the upsurge of mpox 2024 during its first meeting, held on 14 August 2024, has determined, on the same date, that the ongoing upsurge of mpox in the Democratic Republic of the Congo (DRC) and in a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the provisions of the Regulations. The communication of the Director-General regarding the determination of the above-mentioned PHEIC on 14 August 2024 is available here.

The Director-General is hereby transmitting the report of the first meeting of the IHR Emergency Committee regarding the upsurge of mpox 2024.

Noting that the Director-General will be communicating to States Parties a 12-month extension of the current standing recommendations for mpox, the temporary recommendations, issued by the Director-General in relation to the PHEIC associated with the ongoing upsurge of mpox are presented in the last section of this statement and reflect the advice offered by the Committee.

The Director-General is taking the opportunity to express his most sincere gratitude to the Chair, Vice-Chair, and Members of the IHR Emergency Committee, as well as to its Advisors. 

Proceedings of the meeting

Sixteen (16) Members of, and two Advisors to, the Emergency Committee were convened by teleconference, via Zoom, on Wednesday, 14 August 2024, from 12:00 to 17:00 CEST. Fifteen (15) of the 16 Committee Members and the two Advisors to the Committee participated in the meeting.

The Director-General of the World Health Organization (WHO) joined in person and welcomed the participants. The opening remarks by the Director-General are available here.

The Representative of the Office of Legal Counsel briefed the Members and Advisers on their roles and responsibilities and identified the mandate of the Emergency Committee under the relevant articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics provided the Members and Advisors with an overview of the WHO Declaration of Interests process. The Members and Advisors were made aware of their individual responsibility to disclose to WHO, in a timely manner, any interests of a personal, professional, financial, intellectual or commercial nature that may give rise to a perceived or actual conflict of interest. They were additionally reminded of their duty to maintain the confidentiality of the meeting discussions and the work of the Committee. Each Member and Advisor was surveyed, with no conflicts of interest identified.

The Representative of the Office of Legal Counsel then facilitated the election of officers of the Committee, in accordance with the rules of procedures and working methods of the Emergency Committee. Professor Dimie Ogoina was elected as Chair of the Committee, Professor Inger Damon as Vice-Chair, and Professor Lucille Helen Blumberg as Rapporteur, all by acclamation.

The meeting was handed over to the Chair who introduced the objectives of the meeting, which were to provide views to the Director-General on whether the event constitutes a public health emergency of international concern (PHEIC), and if so, to provide views on the potential proposed temporary recommendations.  

Session open to representatives of States Parties invited to present their views

The WHO Secretariat presented an overview of the global epidemiological situation of mpox, highlighting that, during the first six months of 2024, the 1854 confirmed cases of mpox reported by States Parties in the WHO African Region account for 36% (1854/5199) of the cases observed worldwide. Of these confirmed cases in the WHO African region in 2024, 95% (1754/1854) were reported in the Democratic Republic of the Congo (DRC), that is experiencing an upsurge of cases of mpox, with more than 15,000 clinically compatible cases and over 500 deaths reported, already exceeding the number of cases observed in the DRC in 2023.

The upsurge of mpox cases in the DRC is being driven by outbreaks associated with two sub-clades of clade I monkeypox virus (MPXV) – clade Ia and clade Ib. Clade I mpox was classically described in studies conducted by WHO in the 1980’s to have a mortality rate of approximately 10%, with most deaths occurring in children.

MPXV clade Ia is endemic in the DRC, the disease primarily affects children, data available for 2024 show an aggregated case fatality rate of 3.6%, and the spread is likely sustained through multiple modes of transmission including person-to-person transmission following zoonotic introduction in a community.

MPXV clade Ib is a new strain of MPXV that emerged in the DRC  is transmitting between people, presumed via sexual contact, which has been spreading in the eastern part of the country. Although first characterized in 2024, estimates suggest it emerged around September 2023. The outbreak associated with clade Ib in the DRC primarily affects adults and is spreading rapidly, sustained largely, but not exclusively, through transmission linked to sexual contact and amplified in networks associated with commercial sex and sex workers.

Since July 2024, cases of mpox due to MPXV clade Ib, epidemiologically and phylogenetically linked to the outbreak in the eastern provinces of DRC, have been detected in four countries, neighbouring the DRC, which had not reported cases of mpox before: Burundi, Kenya, Rwanda and Uganda.

Additionally, in 2024, cases of mpox linked to MPXV clade Ia have been reported in the Central African Republic and the Republic of Congo, and cases linked to MPXV clade II have been reported in Cameroon, Côte d’Ivoire, Liberia, Nigeria and South Africa.

The clinical presentation of mpox associated with MPXV clade Ia has historically been characterized by more severe disease than that associated with MPXV clade II. Clade IIb viruses circulated during the multi-country outbreak that constituted a PHEIC from July 2022 to May 2023. There is, as yet, insufficient information available to fully characterize mpox severity due to clade Ib as data are emerging and, so far, few deaths were recorded, precluding age-stratified analyses.

The secretariat outlined challenges in understanding the true extent of infection, epidemiologic trends and morbidity and mortality, thus cautioning overinterpretation of available data to calculate crude CFRs by different clades/outbreaks.

The assessed risk presented by the WHO Secretariat – grouping geographical areas as a result of the assessment of population groups affected, predominant modes of transmission, and MPXV clades involved –, was: “high” for eastern DRC and neighbouring countries; “high” for areas of the DRC where mpox is known to be endemic; “moderate” for Nigeria and countries of West, Central and East Africa where mpox is endemic; and “moderate” for other countries in Africa and around the world.

The WHO Secretariat additionally provided an overview of the actions already taken to support readiness and response interventions in States Parties experiencing the upsurge of cases of mpox and facing such risk. These include, inter alia: the release of USD 1.45 million from the WHO Contingency Fund for Emergencies; initiating the process for including Emergency Use Listing two mpox vaccines; coordinating with partners and stakeholders, including to facilitate equitable access to vaccines, therapeutics, and diagnostics; the development of a regional response plan, costed at an initial USD 15 million, and more.

Representatives of Burundi, the Democratic Republic of the Congo, Kenya, Rwanda, South Africa and Uganda updated the Committee on the mpox epidemiological situation in their countries and the current response efforts, needs and challenges. Although most reported few cases of MPXV clade Ib related mpox, Burundi reported one hundred confirmed cases of mpox associated with clade Ib since July 2024, identified in multiple districts and 28% of cases were amongst children less than five years of age.

Members of, and Advisors to, the Committee then engaged in questions and answers with the presenters. The questions and discussions focused around the issues and challenges enumerated below:

• The observed complex and dynamic evolution of the multiple outbreaks driving the upsurge of mpox, and related international spread, of mpox in the DRC and neighbouring countries. Elements underpinning such observation, and representing reasons for concern, including:
  • Scientific uncertainties and evidence gaps (e.g., role of ecological changes in the spread of mpox, modes of disease transmission, transmission dynamics, risk factors, disease severity and case fatality rate associated with the different MPXV clades, outcome of pregnancy in women infected with different MPXV clades);
  • Adequacy of capacities, recognizing capacities gained during COVID-19, and heterogeneity thereof, across States Parties for surveillance, diagnostic capacities, surveillance modalities at borders, access to clinical care, integration of HIV/STI services in prevention and treatment, and risk communication and community engagement, vaccination delivery, and other capacities to support prevention, readiness and response activities;
  • Lack of full understanding of the geographical spread and detailed epidemiology of the dynamic mpox outbreaks, including of molecular epidemiology, to optimize targeted prevention and control measures, including risk communication and community engagement with local partners to enable appropriate support and behavior modifications, as well as the targeted use of mpox vaccines in at risk groups;
  • Availability and access to laboratory tests that can be used in challenging environments, and where necessary, methods to distinguish between circulating MPXV clades; and
  • An incomplete mapping of mpox-related research and development efforts underway, noting several initiatives underway, including a WHO and Africa Centers for Disease Control and Prevention (Africa CDC) consultation to be held in August 2024;
• The unpredictability and lack of financial resources at both, national and international levels to scale up and sustain interventions to prevent and control the spread of mpox, despite the development of costed global, regional and national response plans;
• The needs-based access to mpox vaccines, given the current limited available globally; the currently limited production of the vaccine, conditional to orders placed to the manufacturer; and the extensive time to develop legal agreements in relation to donation of mpox vaccines, as opposed to direct procurement. With respect to access to vaccines, the WHO Secretariat informed the Committee of its ongoing work with numerous partners through the Interim coordination mechanism for medical countermeasures (i-MCM-Net), including Gavi and the United Nations Children's Fund on the coordination of the donation and allocation process in an equitable, needs-based manner;
• The access to the antiviral drug tecovirimat, considering that both, the minimum amount for orders to be placed with the manufacturer and the price of the product represent key challenges for many States Parties. While evidence is being gathered on its use for the treatment of cases of mpox, it can be accessed under protocol for Monitored Emergency Use of Unregistered and Experimental Interventions (MEURI); as well as optimized and safe clinical care; and
• The need for information on the implementation, by States Parties, of the standing recommendation for mpox issued on 21 August 2023.

Deliberative session

Following the session open to invited States Parties, the Committee reconvened in a closed session to examine the questions in relation to whether the event constitutes a PHEIC or not, and if so, to consider the temporary recommendations drafted by the WHO Secretariat in accordance with IHR provisions.

The Chair reminded the Committee Members of their mandate and recalled that a PHEIC is defined in the IHR as an “extraordinary event, which constitutes a public health risk to other States through the international spread of disease, and potentially requires a coordinated international response”.

The Committee was unanimous in expressing the views that the ongoing upsurge of mpox meets the criteria of a PHEIC and that the Director-General be advised accordingly.

The considerations underpinning the unanimous views of the Committee further elaborated upon issues and challenges addressed during the question and answers session.

The Committee considered the event as “extraordinary” because of (a) the increase in mpox clade I disease occurrence in the DRC and the emergence of the new MPXV clade Ib, the human-to-human transmission context in which it is occurring, its rapid spread in some settings, and available evidence suggesting that MPXV clade I is associated with a more severe clinical presentation with respect to MPXV clade II; (b) the diverse, complex, dynamic, and rapidly evolving epidemiology observed across States Parties in the WHO African Region in terms of: overall rapid increase of the number of cases reported in some settings, differences in population age-groups affected, routes and modes sustaining transmissions in different contexts; and (c) the severity of the clinical presentation in children and immunocompromised individuals, including people living with uncontrolled HIV infection or advanced HIV disease, as well as the long-term consequences of MPXV infection.

Additionally, the Committee strongly underscored that its level of concern is further heightened by (a) uncertainties and gaps in knowledge and evidence related to (i) multiple epidemiological aspects, including drivers of transmission, morbidity and mortality associated with infections with different MPXV sub-clades; (ii) the incompleteness and uncertainties of available epidemiological data and considered by the Committee, due to the limitations of current surveillance (e.g., sub-optimal levels of case detection and case reporting), the availability and performance of laboratory diagnostics, and ongoing conflicts and humanitarian challenges in certain areas of the DRC experiencing the upsurge of mpox, that, ultimately, hamper the implementation of control measures; (iii) the impact of control measures, including the targeted use of vaccines and their overall effectiveness; and (b) the risk of occurrence of additional mutations of MPXV clade I and clade II, and their subsequent emergence and spread in the context of limited capacity to implement control measures.

The Committee considered that the event “constitutes a public health risk to other States through the international spread of disease” because of (a) the documented recent spread of MPXV clade Ib from eastern DRC to Burundi, Kenya, Rwanda and Uganda; (b) the limited capacity to control transmission in endemic situations and in areas of upsurge through enhanced surveillance enabling the implementation of targeted response interventions that are ultimately subordinated to (i) the unavailability of sustainable funding, and (ii) the limited ability to access vaccines, therapeutics, and diagnostics; and (c) the challenges in implementing concerted surveillance and response interventions in contiguous areas of bordering States Parties, in particular where borders are porous.

The Committee considered that the event “requires a coordinated international response”. The Committee noted that (a) mpox is endemic in parts of Africa, with surges increasingly reported, and also resulting in a multi-country outbreak determined to constitute a PHEIC in 2022-2023; and (b) the event is occurring in the context of standing recommendations issued by the Director-General in August 2023 under IHR provisions and following the termination of the afore mentioned PHEIC; the presence of the “WHO Strategic framework for enhancing prevention and control of mpox- 2024-2027”; and the activation for mpox of the i-MCM-Net. In that light and noting the declaration of the event as a Public Health Emergency of Continental Security by the Africa CDC on 13 August 2024, the Committee considered that international cooperation requires enhanced and coordination, in particular with respect to (a) the facilitation of equitable access to vaccines, therapeutics, and diagnostics; and (b) the mobilization of financial resources.

The Committee subsequently considered the draft of the temporary recommendations proposed by the WHO Secretariat, briefly presented during the meeting. The Committee indicated that it would be giving further consideration to the proposed temporary recommendations while finalizing the report of the meeting.

The Committee noted that, in his opening remarks, the Director-General communicated the 12-month extension of the current standing recommendations for mpox, which were set to expire on 20 August 2024. The Committee also noted that, should the Director-General determine that the upsurge of mpox constitutes a PHEIC, it would be the first time, since the entry into force of the Regulations, that temporary and standing recommendations to States Parties related to the same public health risk would coexist.

Therefore, the Committee underscored that any temporary recommendation that may be issued by the Director-General should be very specific and targeted, and hence, not duplicate the standing recommendations.

Notwithstanding that both, temporary and standing recommendations constitute non-binding advice to States Parties, the Committee advised that mechanisms to monitor the uptake, implementation and impact of such recommendations should be embedded in the set of temporary recommendations to States Parties that the Director-General may issue in relation to the event considered.

Conclusions

The Committee reiterated its concern regarding the evolution of the multi-faceted upsurge of mpox, including the many uncertainties surrounding it and the capacities in place to control the spread of mpox in States Parties experiencing the outbreaks, or in States Parties that may have to do so as a result of further international spread.

The Committee recognized the critical role of coordinated international cooperation in supporting States Parties’ efforts to control the spread of mpox in the WHO African Region – including in facilitating access to and use of vaccines, therapeutics, and diagnostics; mobilizing financial resources for States Parties experiencing the upsurge of disease; and synergic initiatives by WHO and partners, including Africa CDC.

Nevertheless, the Committee indicated that the development of strategic approaches for States Parties to become more self-reliant in controlling the spread of mpox are warranted. To that effect, the Committee considers that the determination by the Director-General that the upsurge of mpox constitutes a PHEIC would stimulate States Parties facing the outbreaks to more effectively commit and employ domestic resources. 

Temporary recommendations issued by the Director-General of the World Health Organization (WHO) to States Parties in relation to the public health emergency of international concern associated with the upsurge of mpox 

These temporary recommendations are issued to States Parties experiencing the upsurge of mpox, including, but not limited to, the Democratic Republic of the Congo and Burundi, Kenya, Rwanda, and Uganda.

They are intended to be implemented by those States Parties in addition to the current standing recommendations for mpox, which will be extended until 20 August 2025 and are presented at the end of this document for easy reference. 

In the context of the global efforts to prevent and control the spread of mpox disease outlined in the WHO Strategic framework for enhancing prevention and control of mpox- 2024-2027, the aforementioned standing recommendations apply to all States Parties. 

All current WHO interim technical guidance can be accessed on this page of the WHO website. WHO evidence-based guidance has been and will continue to be updated in line with the evolving situation, updated scientific evidence, and WHO risk assessment to support States Parties in the implementation of the WHO Strategic Framework for enhancing mpox prevention and control. 

Pursuant to Article 3 Principle of the International Health Regulations (2005) (IHR), the implementation of these temporary recommendations, as well as of the standing recommendations for mpox, by States Parties shall be with full respect for the dignity, human rights and fundamental freedoms of persons, in line with the principles set out in Article 3 of the IHR. 

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 Emergency Coordination

• Establish or enhance national and local emergency response coordination arrangements;
• Establish or enhance the coordination of all partners and stakeholders engaged in or supporting response activities through cooperation, including by introducing accountability mechanisms;
• Engage partner organizations for collaboration and support, including humanitarian actors in contexts with insecurity or areas with internal or refugee population displacements and hosting communities insecure areas;

Collaborative Surveillance and Laboratory Diagnostics

• Enhance surveillance, by increasing the sensitivity of the approaches adopted and ensuring comprehensive geographical coverage;
• Expand access to accurate, affordable and available diagnostics to differentiate monkeypox virus clades, including through strengthening arrangements for the transport of samples, the decentralization of diagnostics, and arrangements to conduct genomic sequencing;
• Identify, monitor and support the contacts of people with mpox to prevent onward transmission;
• Scale up efforts to thoroughly investigate cases and outbreaks of mpox disease to elucidate the modes of transmission, and prevent its onward transmission to household members and communities;
• Report to WHO suspect, probable and confirmed cases of mpox in a timely manner and on a weekly basis;

Safe and Scalable Clinical Care

• Provide clinical, nutritional and psychosocial support for patients with mpox, including, as warranted and possible, isolation in care centres and guidance for home-based care;
• Develop and implement a plan to expand access to optimised supportive clinical care for all patients with mpox, including children, patients living with HIV and pregnant women. This includes offering HIV tests to adult patients who do not know their HIV status and to children as appropriate, with linkages to HIV treatment and care services when indicated; the prompt identification and effective management of endemic co-infections, such as malaria, varicella zoster and measles viruses, and other sexually transmitted infections (STIs) among cases linked to sexual contact;
• Strengthen health and care workers’ capacity, knowledge and skills in the clinical and infection and prevention and control pathways –from diagnosis to discharge of patients with suspected and confirmed mpox –, and provide them with personal protective equipment;
• Promote and implement infection prevention and control measures and basic water and sanitation services in health care facilities, household settings, congregate settings (e.g. prisons, internally displaced persons and refugee camps, schools, etc.), and cross border transit areas;

International traffic

• Establish or strengthen cross-border collaboration arrangements for surveillance and management of suspect cases of mpox, the provision of information to travellers and conveyance operators, without resorting to general travel and trade restrictions unnecessarily impacting local, regional or national economies;

Vaccination

• Prepare for the introduction of mpox vaccine for emergency response through convening of national immunization technical advisory groups, briefing of national regulatory authorities, preparing national policy mechanisms to apply for vaccines through available mechanisms;
• Initiate plans to advance mpox vaccination activities in the context of outbreak response in areas with incident cases (i.e. with disease onset in the previous 2-4 weeks), targeting people at high risk of infection (e.g., contacts of cases, including sexual contacts, children, and health and health care workers). This entails the agile adaptation of immunization strategies and plans to concerned areas; the availability of vaccines and supplies; the proactive community engagement, to generate and sustain demand for and trust in vaccination; and the collection of data during vaccination according to implementable research protocols;

Risk communication and community engagement

• Strengthen risk communication and community engagement systems with affected communities and local workforces for outbreak prevention, response and vaccination strategies, including through training, mapping high risk and vulnerable populations, social listening and community feedback, managing misinformation. This entails, inter alia, communicating effectively the uncertainties regarding the natural history of mpox, updated information about mpox including information from ongoing clinical trials, about the efficacy of vaccines against mpox, and the uncertainties regarding duration of protection following vaccination;
• Address stigma and discrimination of any kind via meaningful community engagement, particularly in health services and during risk communication activities;

Governance and financing

• Galvanize and scale up national funding and explore external opportunities for targeted funding of prevention, readiness and response activities;
• Integrate mpox prevention and response measures in existing programmes aimed at prevention, control and treatment of other endemic diseases – especially HIV, as well as STIs, malaria, tuberculosis, and COVID-19, as well as non-communicable diseases –, striving, to the extent possible, not to negatively impact their delivery;

Addressing research gaps

• Invest in addressing knowledge gaps and in generating evidence, during and after outbreaks, regarding the dynamics of transmission of mpox, risk factors, the social and behavioural drivers of transmission, the natural history of disease, through trials for novel therapeutics and vaccines against mpox, the effectiveness of public health interventions, with a One Health approach;

Reporting on the implementation of temporary recommendations

• Report quarterly to WHO on the status of, and challenges related to the implementation of these temporary recommendations, using a standardized tool and channels that will be made available WHO.

Standing recommendations for mpox issued by the Director-General of the World Health Organization (WHO) in accordance with the International Health Regulations (2005) (IHR)

A. States Parties are recommended to develop and implement national mpox plans that build on WHO strategic and technical guidance, outlining critical actions to sustain control of mpox and achieve elimination of human-to-human transmission in all contexts through coordinated and integrated policies, programmes and services. Actions are recommended to:

1. Incorporate lessons learned from evaluation of the response (such as through intra- or after-action reviews) into related plans and policies in order to sustain, adapt, and promote key elements of the response and inform public health policies and programmes.
2. Aim to eliminate human-to-human transmission of mpox by anticipating, detecting, preparing for and responding to mpox outbreaks and taking action to reduce zoonotic transmission, as appropriate.
3. Build and retain capacity in resource-limited settings, and among marginalized groups, where mpox transmission continues to occur, to improve understanding of modes of transmission, quantify resource needs, and detect and respond to outbreaks and community transmission.

B. States Parties are recommended to, as a critical basis for actions outlined in A in support of the elimination goal, establish and sustain laboratory-based surveillance and diagnostic capacities to enhance outbreak detection and risk assessment. Actions are recommended to:

4. Include mpox as a notifiable disease in the national epidemiological surveillance system.

5. Strengthen diagnostic capacity at all levels of the health care system for laboratory and point of care diagnostic confirmation of cases.

6. Ensure timely reporting of cases to WHO, as per WHO guidance and Case Reporting Form, in particular reporting of confirmed cases with a relevant recent history of international travel.

7. Collaborate with other countries so that genomic sequencing is available in, or accessible to, all countries. Share genetic sequence data and metadata through public databases.

8. Notify WHO about significant mpox-related events through IHR channels.

C. States Parties are recommended to enhance community protection through building capacity for risk communication and community engagement, adapting public health and social measures to local contexts and continuing to strive for equity and build trust with communities through the following actions, particularly for those most at risk. Actions are recommended to:

9. Communicate risk, build awareness, engage with affected communities and at-risk groups through health authorities and civil society.

10. Implement interventions to prevent stigma and discrimination against any individuals or groups that may be affected by mpox.

D. States Parties are recommended to initiate, continue, support, and collaborate on research to generate evidence for mpox prevention and control, with a view to support elimination of human-to-human transmission of mpox. Actions are recommended to:

11. Contribute to addressing the global research agenda to generate and promptly disseminate evidence for key scientific, social, clinical, and public health aspects of mpox transmission, prevention and control.

12. Conduct clinical trials of medical countermeasures, including diagnostics, vaccines and therapeutics, in different populations, in addition to monitoring of their safety, effectiveness and duration of protection.

13. States Parties in West, Central and East Africa should make additional efforts to elucidate mpox-related risk, vulnerability and impact, including consideration of zoonotic, sexual, and other modes of transmission in different demographic groups.

E. States Parties are recommended to apply the following measures related to international travel. Actions are recommended to:

14. Encourage authorities, health care providers and community groups to provide travelers with relevant information to protect themselves and others before, during and after travel to events or gatherings where mpox may present a risk.

15. Advise individuals suspected or known to have mpox, or who may be a contact of a case, to adhere to measures to avoid exposing others, including in relation to international travel.

16. Refrain from implementing travel-related health measures specific for mpox, such as entry or exit screening, or requirements for testing or vaccination.

F. States Parties are encouraged to continue providing guidance and coordinating resources for delivery of optimally integrated clinical care for mpox, including access to specific treatment and supportive measures to protect health workers and caregivers as appropriate. States Parties are encouraged to take actions to:

17. Ensure provision of optimal clinical care with infection prevention and control measures in place for suspected and confirmed mpox in all clinical settings. Ensure training of health care providers accordingly and provide personal protective equipment.

18. Integrate mpox detection, prevention, care and research within HIV and sexually transmitted disease prevention and control programmes, and other health services as appropriate.

G. States Parties are encouraged to work towards ensuring equitable access to safe, effective and quality-assured countermeasures for mpox, including through resource mobilization mechanisms. States Parties are encouraged to take action to:

19. Strengthen provision of and access to diagnostics, genomic sequencing, vaccines, and therapeutics for the most affected communities, including in resource-constrained settings where mpox occurs regularly, and including for men who have sex with men and groups at risk of heterosexual transmission, with special attention to those most marginalized within those groups.

20. Make mpox vaccines available for primary prevention (pre-exposure) and post-exposure vaccination for persons and communities at risk of mpox, taking into account recommendations of the WHO Strategic Advisory Group of Experts on Immunization (SAGE).

 

Two rounds of a polio vaccination campaign are expected to be launched at the end of August and September 2024 across the Gaza Strip to prevent the spread of circulating variant type 2 poliovirus (cVDPV2).  

WHO and UNICEF request all parties to the conflict to implement humanitarian pauses in the Gaza Strip for seven days to allow for two rounds of vaccination campaigns to take place. These pauses in fighting would allow children and families to safely reach health facilities and community outreach workers to get to children who cannot access health facilities for polio vaccination. Without the humanitarian pauses, the delivery of the campaign will not be possible. 

During each round of the campaign, the Palestinian Ministry of Health (MoH), in collaboration with the World Health Organization (WHO), the United Nations Children’s Fund (UNICEF), the United Nations Relief and Works Agency for Palestine Refugees (UNRWA) and partners, will provide two drops of novel oral polio vaccine type 2 (nOPV2) to more than 640 000 children under ten years of age.  

The poliovirus was detected in July 2024 in environmental samples from Khan Younis and Deir al-Balah. Worryingly, three children presenting with suspected acute flaccid paralysis (AFP), a common symptom of polio, have since been reported in the Gaza Strip. Their stool samples have been sent for testing to the Jordan National Polio Laboratory. 

Over 1.6 million doses of nOPV2, which is used to stop cVDPV2 transmission, will be delivered to the Gaza Strip. The deliveries of the vaccines and the cold chain equipment are expected to transit through Ben Gurion Airport before arriving in the Gaza Strip by the end of August. It is essential that the transport of the vaccines and cold chain is facilitated at every step of the journey to ensure their timely reception, clearance and ultimately delivery in time for the campaign. 

Detailed plans to support vaccinators and social mobilizers to reach eligible children across the Gaza Strip have been finalized. Vaccination will be administered by 708 teams, including at hospitals, field hospitals, and primary health care centres in each municipality of the Gaza Strip. Around 2700 health workers, including mobile teams and community outreach workers, will support the delivery of both rounds of the campaign. This will be supported by awareness-raising efforts to mitigate the risks of polio infection.   

At least 95 per cent vaccination coverage during each round of the campaign is needed to prevent the spread of polio and reduce the risk of its re-emergence, given the severely disrupted health, water and sanitation systems in the Gaza Strip. 

Other requirements for successful campaign delivery include sufficient cash, fuel and functional telecommunication networks to reach communities with information about the campaign.  

Further efforts are underway to strengthen and expand poliovirus surveillance and routine immunization.  

The Gaza Strip has been polio-free for the last 25 years. Its reemergence, which the humanitarian community has warned about for the last ten months, represents yet another threat to the children in the Gaza Strip and neighboring countries.  A ceasefire is the only way to ensure public health security in the Gaza Strip and the region.   

Notes for editors  

• On 16 July 2024, wastewater test results confirmed that cVDPV2 was detected in six samples collected on 23 June 2024 from Khan Younis and Deir al Balah ES sites in the Gaza Strip. Further sequencing analysis confirmed that these cVDPV2 isolates are linked to a variant poliovirus strain last detected in Egypt in 2023.    

• The Gaza Strip had a high level of vaccination coverage across the population before the escalation of hostilities in October 2023. However, due to the impact of the conflict, routine immunization coverage (for the second dose of inactivated polio vaccine) dropped from 99 per cent in 2022 to less than 90 per cent in the first quarter of 2024, increasing the risk of vaccine-preventable diseases to children, including polio.   

• The risk of cVDPV2 spread, within the Gaza Strip and internationally, remains high given gaps in children's immunity due to disruptions in routine vaccination, decimation of the health system, constant population displacement, malnutrition and severely damaged water and sanitation systems. The situation has also increased the risk of the spread of other vaccine-preventable diseases such as measles as well as cases of diarrhoea, acute respiratory infections, hepatitis A and skin diseases among children.  

 

In a new risk assessment, the European Centre for Disease Prevention and Control (ECDC) has said that it is highly likely that the EU/EEA will see more imported cases of mpox caused by the clade I virus currently circulating in Africa.

The monkeypox virus (MPXV) clade I epidemic that has been affecting the Democratic Republic of the Congo (DRC) since November 2023 has recently spread to several other African countries including Burundi, Rwanda, Uganda and Kenya.

ECDC continues to monitor the monkeypox virus (MPXV) outbreak in Africa.

ESCAIDE, ECDC’s annual scientific conference, will take place as a hybrid event, in Stockholm and online, from 20-22 November 2024.

WHO Director-General Dr Tedros Adhanom Ghebreyesus has determined that the upsurge of mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC) under the International Health Regulations (2005) (IHR).

Dr Tedros’s declaration came on the advice of an IHR Emergency Committee of independent experts who met earlier in the day to review data presented by experts from WHO and affected countries. The Committee informed the Director-General that it considers the upsurge of mpox to be a PHEIC, with potential to spread further across countries in Africa and possibly outside the continent.

The Director-General will share the report of the Committee’s meeting and, based on the advice of the Committee, issue temporary recommendations to countries.

In declaring the PHEIC, Dr Tedros said, "The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives.”

WHO Regional Director for Africa Dr Matshidiso Moeti said, “Significant efforts are already underway in close collaboration with communities and governments, with our country teams working on the frontlines to help reinforce measures to curb mpox. With the growing spread of the virus, we’re scaling up further through coordinated international action to support countries bring the outbreaks to an end.”

Committee Chair Professor Dimie Ogoina said, “The current upsurge of mpox in parts of Africa, along with the spread of a new sexually transmissible strain of the monkeypox virus, is an emergency, not only for Africa, but for the entire globe. Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."

This PHEIC determination is the second in two years relating to mpox. Caused by an Orthopoxvirus, mpox was first detected in humans in 1970, in the DRC. The disease is considered endemic to countries in central and west Africa.

In July 2022, the multi-country outbreak of mpox was declared a PHEIC as it spread rapidly via sexual contact across a range of countries where the virus had not been seen before. That PHEIC was declared over in May 2023 after there had been a sustained decline in global cases.

Mpox has been reported in the DRC for more than a decade, and the number of cases reported each year has increased steadily over that period. Last year, reported cases increased significantly, and already the number of cases reported so far this year has exceeded last year’s total, with more than 15 600 cases and 537 deaths.

The emergence last year and rapid spread of a new virus strain in DRC, clade 1b, which appears to be spreading mainly through sexual networks, and its detection in countries neighbouring the DRC is especially concerning, and one of the main reasons for the declaration of the PHEIC.

In the past month, over 100 laboratory-confirmed cases of clade 1b have been reported in four countries neighbouring the DRC that have not reported mpox before: Burundi, Kenya, Rwanda and Uganda. Experts believe the true number of cases to be higher as a large proportion of clinically compatible cases have not been tested.

Several outbreaks of different clades of mpox have occurred in different countries, with different modes of transmission and different levels of risk.

The two vaccines currently in use for mpox are recommended by WHO’s Strategic Advisory Group of Experts on Immunization, and are also approved by WHO-listed national regulatory authorities, as well as by individual countries including Nigeria and the DRC.

Last week, the Director-General triggered the process for Emergency Use Listing for mpox vaccines, which will accelerate vaccine access for lower-income countries which have not yet issued their own national regulatory approval. Emergency Use Listing also enables partners including Gavi and UNICEF to procure vaccines for distribution.

WHO is working with countries and vaccine manufacturers on potential vaccine donations, and coordinating with partners through the interim Medical Countermeasures Network to facilitate equitable access to vaccines, therapeutics, diagnostics and other tools.

WHO anticipates an immediate funding requirement of an initial US$ 15 million to support surveillance, preparedness and response activities. A needs assessment is being undertaken across the three levels of the Organization.

To allow for an immediate scale up, WHO has released US$ 1.45 million from the WHO Contingency Fund for Emergencies and may need to release more in the coming days. The Organization appeals to donors to fund the full extent of needs of the mpox response.

 

The expected seasonal increase of locally acquired West Nile virus (WNV) infections in Europe was observed as of July this year, indicating that the transmission season is well under way.

WHO has today issued an invitation for manufacturers of mpox vaccines to submit an Expression of Interest for Emergency Use Listing (EUL).

The WHO Director-General announced on 7 August 2024 that he had triggered the process for EUL of mpox vaccines given worrying trends in the disease’s spread. There is a serious and growing outbreak in the Democratic Republic of the Congo (DRC) that has now expanded outside the country. A new viral strain, which first emerged in September 2023, has for the first time been detected outside DRC.

The EUL procedure is an emergency use authorization process, specifically developed to expedite the availability of unlicensed medical products like vaccines that are needed in public health emergency situations. This is a time-limited recommendation, based on a risk-benefit approach.

WHO is requesting manufacturers to submit data to ensure that the vaccines are safe, effective, of assured quality and suitable for the target populations.

Granting of an EUL will accelerate vaccine access particularly for those lower-income countries which have not yet issued their own national regulatory approval. The EUL also enables partners including Gavi and UNICEF to procure vaccines for distribution.

Mpox is a viral illness caused by the monkeypox virus, a species of the genus Orthopoxvirus. Mpox can be transmitted to humans through physical contact with someone who is infectious, with contaminated materials, or with infected animals.

There are currently two vaccines in use against the disease, both of which have been recommended for use by the WHO Strategic Advisory Group of Experts on Immunization, or SAGE.

 

Since the disease was first identified in Saudi Arabia in April 2012, approximately over 2 600 MERS-CoV cases have been detected in over 27 countries.

According to the ECDC Threat Assessment Brief on Oropouche virus (OROV) disease published today, between June and July 2024, 19 imported cases of OROV disease have been reported for the first time in European Union (EU) countries, all linked to travels in Cuba and Brazil.

In June and July 2024, 19 imported cases of Oropouche virus disease were reported for the first time in European Union countries.

The Coalition for Epidemic Preparedness Innovations (CEPI) and the World Health Organization (WHO) today called on researchers and governments to strengthen and accelerate global research to prepare for the next pandemic.

In the last 12 years, the number of infants under six months of age globally who are exclusively breastfed has increased by more than 10%. This means 48% of infants worldwide now benefit from this healthy start in life. It translates to hundreds of thousands of babies whose lives have been saved by breastfeeding.

While this significant leap brings us closer to the World Health Organization target of increasing exclusive breastfeeding to at least 50% by 2025, there are persistent challenges that must be addressed.

When mothers receive the support they need to breastfeed their babies, everyone benefits. Improving breastfeeding rates could save over 820 000 children’s lives each year, according to the latest available data. 

During this critical period of early growth and development, the antibodies in breastmilk protect babies against illness and death. This is especially important during emergencies, when breastfeeding guarantees a safe, nutritious, and accessible food source for infants and young children. Breastfeeding reduces the burden of childhood illness, and the risk of certain types of cancers and noncommunicable diseases for mothers. 

This World Breastfeeding Week, under the theme “Closing the gap: Breastfeeding support for all”, UNICEF and WHO are emphasizing the need to improve breastfeeding support as a critical action for reducing health inequity and protecting the rights of mothers and babies to survive and thrive.

An estimated 4.5 billion people – that’s more than half of the world’s population – do not have full coverage of essential health services, so many women do not receive the support they need to optimally breastfeed their babies. This includes access to trained, empathetic and respectful health advice and counselling throughout a woman’s breastfeeding journey. 

Reliable data collection is key to tackling healthcare inequalities and ensuring mothers and families are provided with timely, effective breastfeeding support. Currently, only half of all countries collect data on breastfeeding rates. To support progress, data also needs to be available on policy actions that make breastfeeding possible such as family friendly employment policies, regulation of the marketing of breastmilk substitutes, and investment in breastfeeding. Improving monitoring systems will help boost the effectiveness of breastfeeding policies and programmes, inform better decision-making, and ensure support systems can be adequately financed.

When breastfeeding is protected and supported, women are more than twice as likely to breastfeed their infants. This is a shared responsibility. Families, communities, healthcare workers, policymakers, and other decision-makers all play a central role by:    

• increasing investment in programmes and policies that protect and support breastfeeding through dedicated national budgets;
  
• implementing and monitoring family friendly workplace policies, such as paid maternity leave, breastfeeding breaks and access to affordable and good-quality childcare;
  
• ensuring mothers who are at-risk in emergencies or under-represented communities, receive breastfeeding protection and support in line with their unique needs, including timely, effective breastfeeding counselling as part of routine health coverage;
• improving monitoring of breastfeeding programmes and policies to inform and further improve breastfeeding rates; and
• developing and enforcing laws restricting the marketing of breast-milk substitutes, including digital marketing practices, with monitoring to routinely report the Code violations.

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About UNICEF

UNICEF works in some of the world’s toughest places, to reach the world’s most disadvantaged children. Across more than 190 countries and territories, we work for every child, everywhere, to build a better world for everyone.

For more information about UNICEF and its work for children visit www.unicef.org

Follow UNICEF on Twitter, Facebook, Instagram and YouTube

 

About WHO

Dedicated to the well-being of all people and guided by science, the World Health Organization leads and champions global efforts to give everyone, everywhere an equal chance at a safe and healthy life. We are the UN agency for health that connects nations, partners and people on the front lines in 150+ locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to promote health, keep the world safe and serve the vulnerable.

For more information about WHO, visit www.who.int and follow WHO on Twitter, Facebook, Instagram, LinkedIn, TikTok, Pinterest, Snapchat, YouTube, Twitch 

The WHO-India donor agreement is part of a US$ 250 million investment from India in support of the establishment of the WHO Global Centre of Traditional Medicine in 2022, which includes financial support for the workplan of the Centre, interim premises and a new building. This support will scale up WHO’s capacities on traditional medicine across technical divisions and regions in the spirit of global collaboration and solidarity. Part of this substantial contribution from the Government of India will also be included in WHO’s Investment Round to resource WHO’s core work during 2025–2028.

Today, 85 sick and severely injured patients from Gaza were evacuated to Abu Dhabi, United Arab Emirates (UAE), for specialized care. This extremely complex joint evacuation was supported by the the World Health Organization (WHO) in partnership with the Government of the UAE and other partners. This is the largest medical evacuation outside Gaza since October 2023.

“I am immensely grateful to the United Arab Emirates for evacuating sick and severely injured patients from Gaza and providing them with lifesaving medical care,” said Dr Hanan Balkhy, WHO Regional Director for the Eastern Mediterranean. “This initiative is a clear demonstration of the intra-regional solidarity that is urgently needed. Support to people in the Region must start from the Region. Thousands more inside Gaza remain at risk without access to advanced medical care. I urge Member States who are able to receive and care for more patients to do so.”

The patients include 35 children and 50 adults, who were transferred from Gaza via Kerem Shalom to Ramon Airport in Israel, with support from WHO. Fifty-three patients have cancer, including 4 children, 20 have trauma injuries, 3 have blood diseases, including thalassemia, 3 have congenital conditions, 2 have fanconi anaemia, 1 has a neurological condition, 1 has cardiac disease, 1 has liver disease, and 1 has renal failure. Sixty-three family members and care givers accompanied the patients.

“We are thankful to the UAE for supporting the evacuation of these patients to receive the urgent care they need,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. "We hope this paves the way for the establishment of evacuation corridors via all possible routes, including the Kerem Shalom and Rafah crossings to Egypt and Jordan, and from there to other countries. We also call for evacuations to the West Bank, including East Jerusalem, to be restored. Thousands of sick people are suffering needlessly. Above all, and as always, we call for a ceasefire.”

The evacuation, originally scheduled for 29 July, was postponed, adding significant challenges to the operation and diverting scarce resources.

Despite damaged roads, insecurity, and risks to their own safety, the WHO team organized and managed the transfer of patients from various areas in Gaza to the Kerem Shalom crossing under extremely challenging conditions.

Prior to the evacuation, 9 patients were transferred by WHO and partners on July 27 from northern Gaza to the Palestine Red Crescent Society (PRCS) field hospital in Deir al-Balah for stabilization and further movement. Other patients were picked up from five locations in Deir al-Balah and Khan Younis. Some critically injured patients, who had already been relocated to the final departure point in the south, were accommodated and cared for at the Médecins Sans Frontières (MSF) field hospital in Deir al-Balah, in coordination with WHO, following the postponement of the mission. WHO and the International Medical Corps team provided medical supplies, electricity, safe water and sanitation facilities at the hospital as it is still being set up.

During the evacuation, patients underwent back-to-back transfer at Kerem Shalom, where they boarded buses, organized by WHO, heading to the airport after security checks. WHO provided wheelchairs to ensure patients could safely switch buses at the crossing, arranged access to food, water and medical professionals during the entire journey within Gaza and en route to the airport, and supported patient documentation. 

Other partners supporting the evacuation included the emergency medical teams Cadus and International Medical Corps, MSF Belgium and PRCS.

Since October 2023, around 5000 people have been evacuated for treatment outside Gaza, with over 80% receiving care in Egypt, Qatar and the UAE. Over 10 000 more people in Gaza still need medical evacuation. Today’s evacuation follows previous ones to Spain and Belgium from Cairo, coordinated by WHO. Twenty patients have been evacuated to these countries in the past few days.

WHO continues to call on the international community to intensify efforts to ensure safe, sustained, timely, and organized medical evacuations.

 

The European Centre for Disease Prevention and Control (ECDC) is working closely with Africa CDC, and local and international partners to monitor and respond to a worsening mpox outbreak in the Democratic Republic of the Congo (DRC) where a new variant of the mpox virus has emerged.

Among adolescent girls who have been in a relationship, nearly a quarter (24%) – close to 19 million – will have experienced physical and/or sexual intimate partner violence by the time they turn 20 years old, as highlighted by a new analysis from the World Health Organization (WHO) published today in The Lancet Child & Adolescent Health. Almost 1 in 6 (16%) experienced such violence in the past year.

“Intimate partner violence is starting alarmingly early for millions of young women around the world,” said Dr Pascale Allotey, Director of WHO’s Sexual and Reproductive Health and Research Department. “Given that violence during these critical formative years can cause profound and lasting harms, it needs to be taken more seriously as a public health issue – with a focus on prevention and targeted support.”

Partner violence can have devastating impacts on young people’s health, educational achievement, future relationships, and lifelong prospects. From a health perspective, it heightens the likelihood of injuries, depression, anxiety disorders, unplanned pregnancies, sexually transmitted infections, and many other physical and psychological conditions.

High rates of violence against adolescent girls reflect deeply entrenched inequalities

This study draws on existing data to provide, for the first time, a detailed analysis of the prevalence of physical and/or sexual partner violence experienced by 15–19-year-old girls who have been in intimate relationships. It also identifies broader social, economic and cultural factors that increase their risks.

While violence against adolescent girls occurs everywhere, the authors highlight significant differences in prevalence. Based on WHO’s estimates, the worst affected regions are Oceania (47%) and central sub-Saharan Africa (40%), for instance, while the lowest rates are in central Europe (10%) and central Asia (11%). Between countries, there is also a substantive range: from an estimated 6% adolescent girls subjected to such violence in the least affected countries, to 49% in those with the highest rates.  

The new analysis found that intimate partner violence against adolescent girls is most common in lower-income countries and regions, in places where there are fewer girls in secondary school, and where girls have weaker legal property ownership and inheritance rights compared to men. Child marriage (before the age of 18 years) significantly escalates risks, since spousal age differences create power imbalances, economic dependency, and social isolation – all of which increase the likelihood of enduring abuse.

Adolescent girls need targeted services and support

The study highlights the urgent need to strengthen support services and early prevention measures tailored for adolescents, alongside actions to advance women’s and girls’ agency and rights – from school-based programmes that educate both boys and girls on healthy relationships and violence prevention, to legal protections, and economic empowerment. Since many adolescents lack their own financial resources, they can face particular challenges in leaving abusive relationships.

“The study shows that to end gender-based violence, countries need to have policies and programmes in place that increase equality for women and girls,” said study author Dr Lynnmarie Sardinha, Technical Officer for Violence Against Women Data and Measurement at WHO. “This means ensuring secondary education for all girls, securing gender-equal property rights and ending harmful practices such as child marriage, which are often underpinned by the same inequitable gender norms that perpetuate violence against women and girls.”

Currently, no country is on track to eliminate violence against women and girls by the 2030 Sustainable Development Goal target date. Ending child marriage – which affects 1 in 5 girls globally – and expanding girls’ access to secondary education will be critical factors for reducing partner violence against adolescent girls.

WHO supports countries to measure and address violence against women, including efforts to strengthen prevention and response within the health care sector. New WHO guidelines on prevention of child marriage are planned for release by the end of 2024.

 

Notes for editors

The study, Intimate partner violence against adolescent girls: regional and national prevalence estimates and associated country-level factors, analyzes both lifetime prevalence and prevalence over the past 12 months of physical and/or sexual partner violence against 15-19 year old girls. Other types of violence, including psychological violence, are not included due to lack of an agreed internationally comparable measure.

It uses data from WHO’s Global database on prevalence of violence against women, published in 2018, which draws on data collected between 2000 and 2018 from 161 countries. Bayesian hierarchical modelling methods were used to generate internationally comparable estimates between countries.

This study was funded by the UK Foreign and Commonwealth Development Office through the WHO-UN Women Joint Programme on Strengthening Violence Against Women Data, and the United Nations’ Special Programme of Research, Development, and Research Training in Human Reproduction (HRP).

Link to the article: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(24)00145-7/fulltext

 

A new project aiming to accelerate the development and accessibility of human avian influenza (H5N1) messenger RNA (mRNA) vaccine candidates for manufacturers in low- and middle-income countries has been launched today. The Argentinian manufacturer Sinergium Biotech will lead this effort leveraging the World Health Organization (WHO) and the Medicines Patent Pool (MPP) mRNA Technology Transfer Programme.

The mRNA Technology Transfer Programme, jointly developed by WHO and MPP, was launched in July 2021 with the aim to build capacity in low- and middle-income countries (LMICs) for the development and production of mRNA-based vaccines. Sinergium Biotech, a partner in the mRNA Technology Transfer Programme, has developed candidate H5N1 vaccines and aims to establish proof-of-concept in preclinical models. Once the preclinical data package is concluded, the technology, materials, and expertise will be shared with other manufacturing partners, aiding the acceleration of the development of H5N1 vaccine candidates, and bolstering pandemic preparedness efforts.

"This initiative exemplifies why WHO established the mRNA Technology Transfer Programme – to foster greater research, development and production in low- and middle-income countries, so that when the next pandemic arrives, the world will be better prepared to mount a more effective and more equitable response," said Dr Tedros Adhanom Ghebreyesus, WHO Director-General.

"When we created the mRNA Technology Transfer Programme with WHO, our goal was to enable low- and middle-income countries to lead development efforts, foster collaboration, share resources, and disseminate knowledge,” said Charles Gore, Executive Director of MPP. “This project embodies our vision and demonstrates a strong commitment to future pandemic preparedness and response."

Avian influenza viruses are a significant public health risk due to their widespread circulation in animals and potential to cause a future pandemic. This development supplements ongoing work under the Pandemic Influenza Preparedness Framework to improve and strengthen the sharing of influenza viruses with human pandemic potential and increasing LMIC access to vaccines.

“This announcement underscores the importance of not only geographically diversifying the innovation and production of health technologies including and recognizing the capacities in Latin American and the Caribbean, but also the importance of early planning for access and the sharing of knowledge and technologies during the research and development processes," said Dr Jarbas Barbosa, Director of the Pan American Health Organization.

Dr Alejandro Gil, Chief Executive Officer of Sinergium, said, "Sinergium’s enhanced capacity and readiness to apply our expertise to H5N1 will play a vital role in this effort towards global pandemic preparedness. I would also like to thank PAHO who have also been instrumental through the strong support it offers to regional manufacturers in the Americas. We are excited to tackle this public health challenge and our R&D team will continue to work closely with the Programme Partners."

Since its inception, the mRNA Technology Transfer Programme has developed and implemented a platform that was used to establish the immunogenicity, efficacy, and safety of a COVID-19 vaccine candidate in preclinical animal models. Afrigen is the centre where the platform was created and is being validated and this technology is now being transferred to manufacturing partners to adapt and enhance it for other critical disease targets. The progress made by the mRNA Technology Transfer Programme is a vital part of WHO and MPP’s efforts to improve the availability, access, and use of mRNA vaccines for better vaccine equity globally.