The World Health Organization (WHO) has declared mpox an international public health emergency for the second time in two years, as rising cases and fatalities are reported in several east and central African countries. This declaration follows the Africa Centres for Disease Control and Prevention’s (Africa CDC) recent announcement of a continent-wide public health emergency concerning mpox.
While many nations outside Africa effectively curtailed the mpox pandemic that began in 2022, significant outbreaks persist in the Democratic Republic of the Congo (DRC). The circulating strain there is more lethal than the variants that previously spread to the US and Europe, and it has recently extended its reach into four additional east and central African countries.
Mpox, once known as monkeypox, is an infectious disease closely related to smallpox, but less severe. It is believed to be transmitted from African rodents and non-human primates to humans. The virus spreads through close contact with infected individuals, including sexual and skin-to-skin contact. Pregnant individuals can also transmit the virus to their offspring. Key symptoms include a blister-like rash, fever, fatigue, muscle aches, cough, and sore throat.
Historically, mpox has caused sporadic cases and outbreaks in Nigeria, the DRC, and several other African nations. Two main strains exist: clade I typically associated with more severe illness confined to central Africa, and clade II, chiefly causing infections in west Africa.
The emergence of mpox cases outside Africa began in May 2022, prompting the WHO to declare the pandemic a public health emergency of international concern by July of that year. By May 2023, over 100 countries recorded nearly 90,000 cases and more than 150 deaths related to mpox.
In response, public health agencies globally enhanced disease surveillance, raised awareness among high-risk populations—especially men who have sex with men—and promoted safe sex practices. Incessant distributions of vaccine doses led to reduced transmission in the US and Europe. Although the WHO lifted the emergency status in May 2023, cases nevertheless continued to emerge worldwide.
As of June 2024, reported mpox cases included 175 in the Americas, 100 in Europe, and 11 in Southeast Asia, with the situation in the DRC remaining particularly severe. Here, the circulating clade I strain has led to 7,851 cases and 384 fatalities as of May 2024. From the DRC, clade I has now spread to Burundi, Kenya, Rwanda, and Uganda, prompting health organizations to declare fresh emergencies.
The Africa CDC’s move to label the outbreak a continental health emergency marks a significant first for the agency, which represents 55 African states. Despite the obstacles encountered in outbreak response—including challenges experienced during the COVID-19 pandemic—efforts are underway to boost public health infrastructure and lessen dependency on foreign aid.
The origins of mpox can be traced back to a discovery in 1958 involving monkeys and the first human case in 1970 in the DRC. While the precise methods of human transmission remain unclear, the virus has shown a propensity for rapid mutations, complicating responses to outbreaks.
Currently, two vaccines, Jynneos and LC16, have proven effective against mpox. However, during the early stages of the pandemic, only minimal vaccine supplies reached the DRC. Dependency on international donations continues, with recent shipments providing only 200,000 doses for a population exceeding 100 million.
As funding to support mpox response mobilizes, the Africa CDC and organizations like USAID are stepping in, pledging significant financial assistance. The organization’s Director General, Jean Kaseya, emphasized the necessity of collective action against mpox, signaling ongoing global health collaboration in tackling the crisis.