Saatja:
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Teema: WHO: C.L.38.2024 (Standing recommendations for mpox)
Kuupäev: 2024-08-21 14:25
Dear Member States of the World Health Organization,
Please find attached, in the six official languages, C.L.38.2024 regarding
the extension of standing recommendations for mpox.
Best regards,
Department of Governing Bodies
World Health Organization
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20, AVENUE APPIA – CH-1211 GENEVA 27 – SWITZERLAND – TEL CENTRAL +41 22 791 2111 – FAX CENTRAL +41 22 791 3111 – WWW.WHO.INT
Ref.: C.L.38.2024
Extension of standing recommendations for mpox
The Director-General of the World Health Organization presents his compliments to States
Parties to the International Health Regulations (2005) (hereinafter “the IHR” or “Regulations”) and
has the honour to refer to Articles 16 and 53 of the IHR. Pursuant to these provisions and on the
advice of the Review Committee regarding standing recommendations for mpox, on
21 August 2023, the Director-General issued standing recommendations to States Parties to prevent
or reduce the international spread of mpox. These recommendations were presented to the
consideration of the Seventy-seventh World Health Assembly in document A77/8 Add. 4, and will
expire on 20 August 2024.
Considering the current global epidemiological situation of mpox, underpinning the
determination, on 14 August 2024, that the ongoing upsurge of mpox constitutes a public health
emergency of international concern (PHEIC), as well as of the ongoing roll-out of the WHO
“Strategic framework for enhancing prevention and control of mpox- 2024–2027”, the
Director-General of the World Health Organization has extended the above-mentioned set of
... standing recommendations until 20 August 2025.
The Director-General of the World Health Organization will communicate to the
Seventy-eighth World Health Assembly, the extension of the above-mentioned standing
recommendations for mpox.
The Director-General of the World Health Organization takes this opportunity to renew to
States Parties to the International Health Regulations (2005) the assurance of his highest
consideration.
GENEVA, 21 August 2024
... ENCL.: (1)
Enclosure 1
EXTENSION OF THE STANDING RECOMMENDATIONS FOR MPOX
ISSUED BY THE DIRECTOR-GENERAL OF THE WORLD HEALTH
ORGANIZATION (WHO) IN ACCORDANCE WITH THE INTERNATIONAL
HEALTH REGULATIONS (2005) (IHR)
These standing recommendations are issued by the Director-General of the World Health
Organization (WHO) in accordance with provisions of Articles 16 to 18, and 50 to 53 of the International
Health Regulations (2005) (IHR or Regulations).
These standing recommendations, based on scientific principles and evidence, represent an extension
of the standing recommendations for mpox issued on 21 August 2023,1 taking into consideration the advice
of the IHR Review Committee regarding standing recommendations for mpox,2
The extension of these standing recommendations is necessary to support States Parties in addressing
the risk posed by mpox and to prevent or reduce the international spread of disease.
These standing recommendations are in effect for all States Parties until 20 August 2025.
These standing recommendations may be modified or terminated prior to that time, in accordance
with Article 53 of the Regulations. Furthermore, they will be submitted to the Seventy-eighth World Health
Assembly for its consideration, pursuant to Article 53 (g) of the IHR.
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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.
1
https://www.who.int/publications/m/item/standing-recommendations-for-mpox-issued-by-the-director-general-of-
the-world-health-organization-(who)-in-accordance-with-the-international-health-regulations-(2005)-(ihr) [accessed
on 6 August 2024]
2
https://www.who.int/teams/ihr/ihr-review-committees/review-committee-regarding-standing-recommendations-for-
mpox [accessed on 15 August 2023].
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).
Geneva, 21 August 2024
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