Over the weekend, the World Health Organization (WHO) raised the risk level of monkeypox to a global health emergency, the WHO’s highest level of alert. The decision came as case numbers are rising and outside pressure on the WHO has also been mounting.

“WHO’s assessment is that the risk of monkeypox is moderate globally and in all regions except in the European region, where we assess the risk is high. There is also a clear risk of further international spread, although the risk of interference with international traffic remains low, for the moment,” WHO Director-General Tedros Adhanom Ghebreyesus said Saturday. “So in short, we have an outbreak that has spread around the world rapidly through new modes of transmission, about which we understand too little and which meets the criteria in the international health regulations.”

The emergency declaration comes despite the majority of committee members voting against a Global Health Emergency last week. The disease is heavily concentrated among men who have sex with men.

“That means that this is an outbreak that can be stopped with the right strategies in the right groups,” Ghebreyesus said. “It is therefore essential that all countries work closely with communities of men who have sex with men to design and deliver effective information and services, and to adopt measures that protect the health, human rights and dignity of affected communities.”

New York and California have the highest case numbers in the United States. Several rallies have been held in the last week as local leaders called for more action.

“The good news about monkeypox is, if there is any at all, is that it is a familiar threat,” California State Assembly Speaker Anthony Rendon said. “We have tests and we have vaccines. Sadly, despite two years of experience with COVID, our response to monkeypox has been maddeningly slow.”

There are two vaccines against monkeypox licensed by the U.S. Food and Drug Administration: JYNNEOS and ACAM2000. JYNNEOS is reportedly in short supply in the U.S. ACAM2000 is reportedly in ‘ample supply’. However, U.S. health officials said Friday another 100,000 doses are on the way to states. The vaccine should not be used in people who have some health conditions, including a weakened immune system, skin conditions like atopic dermatitis/eczema, or pregnancy.

Across the globe, more than 16,000 cases have been reported. At the end of June, there were about 3,000 cases. For the latest monkeypox numbers across the globe, click here.