A new globalized outbreak of monkeypox (since 28 November 2022 denominated mpox by the World Health Organization, WHO) began in April 2022, expanding the presence of the virus beyond the countries and regions in which it is endemic, and spreading primarily through sexual routes of transmission that had not been identified or associated with other outbreaks. Mpox was declared a Public Health Emergency of International Concern (PHEIC) by the WHO Director-General on July 23, 2022.

This ongoing outbreak has been localized in communities of gay men and other men who have sex with men and transgender people, with additional cases in cis-gender women and children. As of 13 November 2022, 110 countries, territories or areas (per WHO classification) had reported cases, contributing to a global total of 79 411 laboratory confirmed cases and 50 deaths. At that time, 18 countries reported increases in cases, and 63 countries had not reported cases in the last 21 days. Cases in other countries were declining. While the overall trends in declining cases are encouraging, it is possible, if not likely, that many countries and communities that did not have endemic mpox prior to the start of the 2022 outbreak will join West and Central Africa–areas of historic endemicity–as endemic regions with the potential for intermittent outbreaks. The most recent outbreak, which saw high case rates in high-income countries, was characterized by a mobilization of testing, treatment and vaccine strategies that was a stark departure from the response to past and concurrent African outbreaks. Coming two years into the SARS CoV-2 pandemic, the mpox outbreak once again revealed stark global inequities in access to crucial medical countermeasures. This rapid landscape was designed to support continued action and coordination on the part of WHO, industry, funders, governments and communities to ensure reliable and equitable supplies of and global access to medical countermeasures for mpox virus.

This rapid landscape analysis is centered on the antiviral treatment tecovirimat and point-of-care diagnostic tools and does not explore the landscape of mpox vaccine access. It is designed to provide a starting point for discussions, further analysis and action on potential interventions needed to ensure that both testing and treatment can be made readily available for all populations in need.

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