The World Health Organization (WHO) has issued a second international public health emergency declaration concerning mpox as cases rise in East and Central African nations. This announcement follows a recent declaration by the Africa Centres for Disease Control and Prevention (Africa CDC) that deemed mpox a continental public health emergency.
While many non-African countries managed to contain an mpox outbreak that began in 2022, the Democratic Republic of the Congo (DRC) has faced persistent and severe outbreaks. The strain prevalent in the DRC is a more lethal version of the virus that previously affected other regions, and it has now spread to four additional East African countries.
Mpox, formerly known as monkeypox, is a disease related to smallpox but tends to be less severe. It is thought to originate in African rodents and non-human primates and spreads through close contact with infected individuals, including sexual contact. The primary symptom is a blister-like rash that lasts for two to four weeks, accompanied by symptoms like fever, fatigue, and muscle aches.
Historically, mpox had caused infrequent outbreaks mainly in Nigeria and the DRC. However, in May 2022, cases outside Africa began to increase, primarily due to the clade II variant of the virus. The WHO declared these developments a public health emergency for the first time in July 2022. By May 2023, global reports indicated nearly 90,000 cases and over 150 deaths across more than 100 countries.
In response, health authorities worldwide enhanced surveillance and awareness, particularly among high-risk groups, and distributed over a million vaccine doses, which led to a significant decrease in transmission rates. By May 2023, the WHO lifted the emergency status, yet cases continued to be reported globally.
As of June 2024, various regions reported ongoing cases, notably the DRC, where the more dangerous clade I variant has caused over 7,800 cases and 384 fatalities. The recent spread to countries like Burundi, Kenya, and Uganda has raised alarms about the potential for a more lethal pandemic, compelling the Africa CDC and WHO to act decisively.
Dr. Jean Kaseya of the Africa CDC stated that the designation of a continental emergency is meant to mobilize resources and response efforts. However, the response in the DRC faces significant challenges, including a lack of international solidarity and insufficient access to vaccines. While vaccines were made quickly available in the US and Europe, the DRC has only recently started to receive limited supplies.
Efforts to strengthen public health infrastructure across African nations are ongoing, yet it remains to be seen whether the recent emergency declarations will facilitate a faster influx of necessary resources to combat mpox.
Mpox was first identified in the late 1950s, with the first documented human case occurring in the DRC in 1970. The virus can be transmitted by animals to humans, and outbreaks typically become severe when human-to-human transmission takes place. Despite its long history, the virus’s spread has escalated, especially since 2022, raising fears and uncertainties about its future trajectory and the implications for public health.
At present, there is a shortage of effective vaccines against mpox. Though vaccines such as Jynneos and LC16 exist, accessibility remains limited, particularly in the DRC, which relies on imported vaccines and has faced significant delays. Recent shifts in the response include an infusion of funds from USAID and the African Union aimed at addressing the crisis.
The situation continues to develop, with health organizations committing additional resources to enhance the response to mpox and mitigate its impact on communities in Africa.