EXPLAINER: What it means for a disease to be declared a public health emergency

The Africa Centres for Disease Control and Prevention has declared Mpox a Public Health Emergency in the continent.

This comes after cases of Mpox have been reported in some countries in Africa.

Africa CDC Director General Dr Jean Kaseya said Mpox constitutes a public health emergency of continental concern, its highest form of alert.

"We must act now with urgency and purpose. Protect yourself and your loved one. Follow the guidance of health authorities. We must stand together as one continent, united by our resolve to overcome this. Mpox might have taken us by surprise but it will not defeat us," he said.

He said the Centre will in the next few weeks come up with a response plan coming from all national plans.

As a response plan, Kaseya has called for the rapid distribution of 200,000 doses in Africa.

In 2020, Covid 19 pandemic was declared a global health emergency that killed thousands of people.

There are several considerations for a disease to be declared a public health emergency.

Factors leading to the declaration of PHEs in Kenya 

According to the Ministry of Health, management of PHEs involves a varying scope of activities and collaboration with relevant stakeholders.

It may be affected by a variety of factors that include magnitude, location, timing and impact of the event, availability of human and material resources to address it, legal and policy environments and mandates.

Others are the strengths and limitations of emergency response and management agencies and degrees of resilience in individuals, social systems and health service agencies.

There are some important issues to consider when managing a public health emergency.

There needs to be a clear chain of command and reporting structure.

There should also be prompt communication to hasten decision-making and shared situational awareness, as well as coordination of line ministries/ departments, partners, and other agencies to ensure optimal use of resources and avoid role duplication.

According to the US Department of Health and Human Services, under section 319 of the Public Health Service (PHS) Act, the Secretary of the Department of Health and Human Services can declare a public health emergency.

However, the Act is not an exhaustive review of section 319 of the PHS Act or PHE declarations in all contexts, nor a protocol for the Department of Health and Human Services’ implementation of a PHE declaration.

The Secretary can declare a PHE after consulting with public health officials as may be necessary that a disease or disorder presents a PHE including significant outbreaks of infectious diseases or bioterrorist attacks.

A PHE declaration allows the Secretary to take certain actions in response.

Actions taken in response

The secretary may waive or modify certain Medicare, Medicaid, State Children’s Health Insurance Programme (SCHIP) and Health Insurance Portability and Accountability Act(HIPAA) requirements.

May exempt for 30 days a person from select agents requirements as necessary to provide for timely participation of the person in a response to a domestic or foreign public health emergency that involves the select agent or toxin.

The secretary may also adjust medicare reimbursement for certain Part drugs.

They may also declare an emergency under section 564 of the FFDCA justifying an emergency use authorisation (EUA) of unapproved drugs, devices, or biological products, or emergency use authorisation of approved drugs, devices, or biological products for an approved use.

A public health emergency declaration lasts until the Secretary declares that it no longer exists or upon the expiration of the 90 days beginning on the date the Secretary declared a exists, whichever occurs first.

The Secretary may extend the PHE declaration for subsequent 90-day periods for as long as the PHE continues to exist and may terminate the declaration whenever he determines that the PHE has ceased to exist.

On June 23, 2022, the World Health Organisation held the first meeting of the Emergency Committee on the Monkeypox virus, which was convened by International Health Regulations (2005) provisions.

The second meeting of the Emergency Committee on the Monkeypox virus was held on July 21, 2022, following which the Director-General determined the Monkeypox/Mpox outbreak to be a public health emergency of international concern and issued temporary recommendations to countries.