The World Health Organization currently has one active pandemic-level warning: the mpox outbreak, declared a Public Health Emergency of International Concern (PHEIC) on August 14, 2024, and still in effect as of late 2025. Beyond that single formal declaration, the WHO is tracking several other threats that could escalate, including avian influenza in animals and humans, antimicrobial resistance, and the ever-present possibility of an unknown pathogen emerging without warning.
What a WHO Pandemic Warning Actually Means
The WHO’s highest alarm is called a Public Health Emergency of International Concern, or PHEIC. It’s not declared lightly. An event must meet three criteria simultaneously: it must be extraordinary, it must pose a public health risk to other countries through international spread, and it must require a coordinated global response. Before a PHEIC is even considered, individual countries evaluate whether the situation is serious, unusual, and likely to cross borders. If at least two of those conditions are met, they’re required to report it to the WHO.
A group of independent experts called the Emergency Committee then reviews the evidence and advises the WHO Director-General, who makes the final call. Since 2005, when the current system was created, PHEICs have been declared for events including the H1N1 flu pandemic, Ebola outbreaks, Zika, polio, and COVID-19.
Mpox: The Current Active Emergency
The only PHEIC in effect right now centers on a global upsurge of mpox. The emergency was declared in August 2024 after a more dangerous strain, clade I, began spreading rapidly in parts of Africa. By February 2025, the WHO’s Emergency Committee unanimously agreed the situation still warranted emergency status, and the Director-General issued updated temporary recommendations to member states.
The numbers paint a mixed picture. From January through mid-December 2025, 28 African countries reported 43,522 confirmed cases and 197 deaths, a case fatality ratio of 0.5%. Globally in November 2025 alone, 48 countries reported 2,150 new confirmed cases with five deaths. The WHO considers the risk moderate for people with multiple sexual partners and low for the general population without specific risk factors. Standing recommendations were extended through August 2025 and beyond, with emphasis on maintaining surveillance and genomic sequencing, particularly in areas where multiple strains are circulating simultaneously.
Avian Flu: Low Risk, High Vigilance
H5N1 avian influenza isn’t a PHEIC, but it’s the threat that pandemic planners watch most closely. The virus has spread widely in birds and has jumped into dairy cattle in the United States, an unexpected development that increased human exposure. Between December 2024 and March 2025, 17 new human cases of H5 viruses were reported worldwide, with 12 of those in the U.S. among people who had contact with infected animals. Two fatal cases were reported from Cambodia, both linked to sick backyard poultry. Single cases were reported in the United Kingdom and Vietnam.
A joint assessment by the WHO, the Food and Agriculture Organization, and the World Organisation for Animal Health rates the overall global public health risk as low. For people who work directly with poultry or infected livestock, the risk is low to moderate depending on what protective measures are in place. Critically, no human-to-human transmission has been identified in any of these cases. Sustained person-to-person spread of currently circulating H5N1 strains is considered unlikely without further genetic changes in the virus. That qualifier matters: influenza viruses mutate constantly, and the concern is that the right combination of mutations could eventually make the jump easier.
Antimicrobial Resistance: A Slow-Moving Crisis
Unlike a sudden outbreak, antimicrobial resistance (AMR) builds gradually as bacteria, viruses, and fungi evolve to survive the drugs designed to kill them. The WHO has called it a silent pandemic, and the numbers back that up. In 2019, drug-resistant bacteria were directly responsible for an estimated 1.27 million deaths worldwide and contributed to 4.95 million more. That makes AMR one of the leading causes of death globally, though it rarely generates the headlines that a new virus would.
AMR doesn’t trigger a PHEIC because it doesn’t fit neatly into the “extraordinary event” framework. It’s not a single outbreak with a clear start date. Instead, it’s a steady erosion of medicine’s ability to treat common infections, perform surgeries safely, and deliver chemotherapy without lethal complications. The WHO tracks it as an ongoing priority rather than a discrete emergency.
Marburg Virus: A Recent Scare, Now Contained
Rwanda declared an outbreak of Marburg virus disease in late 2024 that briefly raised alarm. Marburg is related to Ebola and carries a high fatality rate. By the time the outbreak was declared over on December 20, 2024, it had caused 66 confirmed cases and 15 deaths, a 23% case fatality ratio. The last confirmed case was reported on October 30, and the last death on October 14. Rwanda waited two full incubation periods (42 days) after the final negative test before officially closing the outbreak. Prior to this, the most recent Marburg outbreaks occurred in Equatorial Guinea and Tanzania between February and June 2023.
New Rules for Reporting Threats
In June 2024, the World Health Assembly agreed on a package of amendments to the International Health Regulations, the legal framework that governs how countries detect and report health emergencies. These amendments came into force on September 19, 2025. The key change: every country must now establish or designate a national authority responsible for coordinating its obligations under the regulations, backed by domestic legislation where appropriate. Countries must share contact details for these authorities with the WHO and confirm them annually.
This sounds bureaucratic, but it addresses a real gap. During COVID-19, communication breakdowns between countries and the WHO slowed the response. Having a clearly identified, legally empowered national authority is meant to eliminate ambiguity about who is responsible for sounding the alarm when something unusual appears.
The First Global Pandemic Agreement
In May 2025, WHO member states formally adopted the world’s first Pandemic Agreement by consensus. The accord is designed to fix the inequities exposed by COVID-19, when wealthy nations hoarded vaccines while lower-income countries waited months or years for access. The agreement establishes principles for equitable and timely access to vaccines, treatments, and diagnostics during future emergencies.
Several major pieces still need to be built. An Intergovernmental Working Group is now drafting the Pathogen Access and Benefit Sharing system, which would create rules for how countries share pathogen samples and, in return, get access to the medical products developed from them. A Coordinating Financial Mechanism for pandemic preparedness and a Global Supply Chain and Logistics Network are also being set up to remove barriers to getting health products to countries that need them. The agreement won’t formally enter into force until 60 countries ratify it through their own legislative processes.
Global Genomic Surveillance
Detecting the next pandemic threat early depends on the ability to sequence pathogen genomes quickly and share that data internationally. The WHO’s Global Genomic Surveillance Strategy, launched in 2022, has set a target: by 2032, all 194 member states should have timely access to genomic sequencing for pathogens with pandemic and epidemic potential. Right now, sequencing capacity is concentrated in wealthier nations. The strategy aims to close that gap so that a new variant or novel pathogen identified in any country can be characterized and shared within days rather than weeks, giving the rest of the world a head start on preparing a response.