Earlier this week, the Africa Centers for Disease Control and Prevention (Africa CDC) labeled the outbreaks a public health emergency due to over 500 deaths and called for international assistance to curb the virus’s spread.
“This is a global concern. The potential for further spread within Africa and beyond is very troubling,” stated WHO Director-General Tedros Adhanom Ghebreyesus.
The Africa CDC has reported that mpox, also known as monkeypox, has been detected in 13 countries this year, with Congo accounting for over 96% of cases and deaths. Cases have surged by 160% and deaths by 19% compared to last year, totaling more than 14,000 cases and 524 deaths.
Salim Abdool Karim, a South African infectious disease expert and chair of the Africa CDC emergency group, expressed concern over the new variant emerging from Congo, which appears to have a death rate of 3-4%.
In 2022, WHO had previously declared mpox a global emergency following its spread to over 70 countries, primarily affecting gay and bisexual men. That outbreak had a mortality rate of less than 1%.
Michael Marks, a professor at the London School of Hygiene and Tropical Medicine, argued that declaring the current outbreaks an emergency is necessary to secure more resources for containment. “It’s a failure of the global community that it took this dire situation to mobilize resources,” he said.
The Africa CDC reported that nearly 70% of cases in Congo are in children under 15, who also account for 85% of deaths. Jacques Alonda, an epidemiologist working in Congo, expressed concern about the spread in refugee camps in conflict zones. He noted a particularly distressing case involving a six-week-old baby who contracted mpox due to overcrowding and lack of diagnosis in a hospital.
Save the Children highlighted that Congo’s health system was already overwhelmed by malnutrition, measles, and cholera before the mpox outbreaks.
The U.N. health agency recently identified mpox in four East African countries—Burundi, Kenya, Rwanda, and Uganda—linked to the Congo outbreak. Meanwhile, Ivory Coast and South Africa have reported outbreaks of a different, less severe form of mpox.
Scientists have detected a new, more lethal variant of mpox in Congo, which may be more transmissible and can kill up to 10% of those infected. This variant presents differently from previous ones, making it harder to identify and control.
While Western countries managed to contain the 2022 outbreak with vaccines and treatments, such resources are scarce in Africa. Marks suggested considering smallpox vaccines as an alternative due to the absence of licensed mpox vaccines in the West. He emphasized the need for a substantial vaccine supply for at-risk populations, including sex workers and children in outbreak regions.
Congo has requested 4 million doses of mpox vaccines, primarily for children under 18, but has not yet received any. The U.S. and Japan have offered to supply vaccines.
Dr. Dimie Ogoina, a Nigerian mpox expert, noted significant gaps in understanding mpox transmission in Africa, which complicates vaccination strategy development.
Previous WHO emergency declarations have yielded mixed results. Dr. Boghuma Titanji of Emory University stressed the importance of taking decisive action now to avoid repeating past mistakes. “The world has a chance to act effectively, but that requires more than just an emergency declaration,” she said.
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