The World Health Organization (WHO) today declared the global spread of monkeypox a Public Health Emergency of International Concern (PHEIC), even though a special advisory committee again declined to recommend the action. This is the first time since the PHEIC system was created in 2005 that the agency has made such a declaration without the panel’s endorsement.

“This is big, unprecedented decision-making by the director general,” says Clare Wenham, a global health expert at the London School of Economics who has studied the history of PHEICs.

WHO’s Emergency Committee, which met on 21 July, did not reach a consensus on whether to declare the burgeoning monkeypox outbreak in more than 70 countries a PHEIC; with a narrow majority voting against doing so. But Tedros Adhanom Ghebreyesus, WHO’s director-general, invoked a PHEIC at a press conference this afternoon in Geneva. “We have an outbreak that has spread around the world rapidly, through new modes of transmission, about which we understand too little and which meets the criteria in the International Health Regulations,” he said.

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