Fourth meeting of the International Health Regulations (2005) (IHR) Emergency Committee on the Multi-Country Outbreak of monkeypox (mpox)

The WHO Director-General transmits the report of the fourth meeting of the International Health Regulations (2005) (IHR) Emergency Committee regarding the multi-country outbreak of monkeypox (mpox), held on Thursday, 9 February 2023

Following a series of consultations with global experts, WHO recommends a new preferred term “mpox” as a synonym for monkeypox in English. Both names will be used simultaneously for one year while the term “monkeypox” is phased out. In English This report uses the term “mpox” (for more information see here).


The Emergency Committee acknowledged the progress made in the global response to the multi-country outbreak of mpox and the further decline in the number of reported cases since the last meeting. The Committee observed that a few countries continued to see a sustained incidence of illness; the Committee is also of the view that underreported detection and under-reporting of confirmed cases of illness in other regions is likely. Therefore, the Committee considered various options to sustain attention and resources to control the outbreak and advised maintaining the Public Health Emergency of International Concern (PHEIC), while beginning to consider plans to integrate mpox prevention, preparedness and response within national surveillance and control programmes, including for HIV and other sexually transmissible infections.

The WHO Director-General expresses his gratitude to the Chair, Members, and Advisers for their advice and concurs with this advice that the event continues to constitute a PHEIC for the reasons detailed in the proceedings of the meeting below and issues revised Temporary Recommendations in relation to this PHEIC, which are presented at the end of this document.

Proceedings of the fourth meeting of the IHR Emergency Committee

The fourth meeting of the IHR Emergency Committee on the multi-country outbreak of mpox was convened by videoconference, with the Chair and Vice-Chair being present in person on the premises of WHO headquarters, Geneva, Switzerland. Thirteen of the fifteen Members and four of the nine Advisors to the Committee participated in the meeting.

In his opening remarks, the WHO Director-General welcomed the Committee, and noted a sustained decline in cases globally, with the majority of cases being reported from the Regions of the Americas. The Director-General also noted the need to sustain efforts for surveillance, prevention and care; vaccinate high-risk populations; improve equitable access to diagnostics, vaccines and treatment for all who need them; and continue to fight stigma and discrimination and ensure respect for human rights. While noting that the continued human-to-human transmission could lead to a resurgence of cases, he concluded that over the longer-term, mpox programmes and services should be integrated into national surveillance and control programmes, including for HIV and other sexually transmitted infections.

The Office of Legal Counsel’s representative briefed the Committee Members and Advisors on their roles, responsibilities, and mandate under the relevant articles of the IHR. The Ethics Officer from the Department of Compliance, Risk Management, and Ethics reminded Members and Advisers of their duty of confidentiality as to the meeting discussions and the work of the Committee, as well as 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 direct conflict of interest.


The meeting was handed over to the Chair of the Emergency Committee, Dr Jean-Marie Okwo-Bele, who introduced the objectives of the meeting: to provide views to the WHO Director-General as to whether the multi-country outbreak of mpox continues to constitute a PHEIC, and, if so, to review the proposed Temporary Recommendations to States Parties.

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