Last week the World Health Organization declared the monkeypox epidemic a Global Health Emergency. California, New York and Illinois have done the same this week. Is the U.S. likely to do the same? When and why would they make such a declaration?

Declaring a public health emergency has a few main purposes: 1) changing policies that you can’t change in a non-emergency; 2) offering contracts you usually can’t offer; and 3) accessing emergency funds that are off limits unless it’s an emergency.

Here’s the Act under which a PH emergency can be declared: (BTW: Health & Human Services Secretary Becerra would declare the emergency, not President Biden)

If Becerra declares an emergency, it will give him a fair amount of added authority to change policy, reassign staff and access emergency funds like:

  • Make grants and enter into contracts and provide supplies, equipment, and services, and reassign HHS staff to work on monkeypox.
  • Allow HHS to access emergency money in the Public Health Emergency Fund to rapidly respond to immediate needs resulting from the PHE
  • Allows CDC to access the Infectious Diseases Rapid Response Reserve Fund
  • Allows HHS to waive certain HIPPA regulations (I can’t see them needing to do that)

There are other authorities a declaration gives HHS agencies- but those are the main things. Interestingly, releasing stuff in the Strategic National Stockpile (e.g., monkeypox/smallpox vaccine) doesn’t require an emergency declaration.

Here’s the list of PH emergencies. Lots of declarations for weather events. For infectious diseases there have been declarations for COVID (of course) but also Zika and H1N1 influenza. Public Health Emergency Declarations

At least for now, it looks like HHS doesn’t intend to declare an emergency. That could change if the new White House monkeypox coordinators (FEMA’s Robert Fenton & Dr. Demetre Daskalakis from Region 9 HHS) determine that an emergency declaration is needed to implement strategies & operations to combat the monkeypox outbreak.

President Biden Announces Team to Lead Monkeypox Response