Health authorities in Europe and the U.S. confirmed cases of monkeypox, a potentially serious viral illness, as the World Health Organization considers whether to declare an international emergency.
Kathy Bergin, professor of disaster law at Cornell Law School, is an expert on the workings of the World Health Organization (WHO) and notes that the WHO has yet to declare a monkeypox emergency and that when it does, travel restrictions are likely to go into place.
“No, the WHO isn’t about to declare an international monkeypox emergency – yet. We have to wait and see whether the WHO convenes its ‘Emergency Committee.’ Even then, the outcome will be hard to predict because the committee will have to consider not only the seriousness of the disease, but whether it is spreading across international borders. A disease being present in different countries won’t automatically trigger an emergency declaration, especially if those countries can treat and contain the disease on their own. In 2013, the emergency committee declined to declare an emergency after MERS was reported in dozens of countries, primarily because most cases were confined to hospitals. But monkeypox is a disease with an especially high mortality rate, so the committee will certainly consider the possibility that it is spreading undetected.
“The WHO has convened its emergency committee nine times, and it has declared six international public health emergencies. The committee waited months before declaring an emergency for Ebola in the Democratic Republic of Congo, and of course came under scrutiny for delaying its response to COVID-19 in 2020. Those delays cost lives, so it’s possible a committee called together to consider monkeypox would be persuaded to move quickly this time.
“If an emergency is declared, the committee will also issue temporary recommendations to member states, and those will almost certainly caution against travel restrictions which, while helpful to limit spread initially, can devastate countries that rely on trade and tourism, especially those with fragile economies and limited health capacities. More than $2 billion was lost in West Africa following the 2014-16 Dbola outbreak, due in part to travel and trade restrictions. Despite all that, however, travel restrictions have been the go-to response for many countries once an international emergency is declared, and the WHO doesn’t have a mechanism to force countries to comply with its recommendations beyond diplomacy or ‘naming and shaming.’”