On Tuesday, the Africa Centers for Disease Control and Prevention (Africa CDC) declared a public health emergency due to the mpox outbreak across the continent. The following day, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus also classified the mpox outbreak in Africa as a "public health emergency of international concern" — a term that was used in regard to COVID-19 and Ebola outbreaks.
African countries like the Democratic Republic of Congo (DRC), South Africa, and the Republic of Congo have been reporting escalating cases of mpox. Now, according to the WHO, mpox has the potential "to spread further across countries in Africa and possibly outside the continent."
What is Mpox?
Mpox (or monkeypox) was named this way after its detection in a colony of laboratory monkeys in 1958. Human infection cases were initially recorded in the DRC in 1970.
It is an infectious disease caused by the monkeypox virus. It may result in fever, swollen lymph nodes, and a painful rash. Furthermore, it is transmitted through direct contact with infected persons (by touch, kissing, or sex), as well as through contact with infected animals and materials. Pregnant women can also transmit the virus to their unborn babies.
There are generally two distinct types, referred to as "clades." Clade I, previously known as the Congo Basin clade, and Clade II, formerly called the West African clade. Both types can be deadly, but historically, Clade I has a higher fatality rate.
Mpox has been documented in the DRC for over a decade, with the number of reported cases increasing steadily each year. Last year saw a significant surge in cases, and this year has already surpassed the previous year’s total, with over 15,600 cases and 537 deaths, according to the WHO.
Why an Emergency Situation?
The recent emergence and swift spread of a new virus strain in the DRC, Clade Ib, which seems to be transmitted primarily through sexual networks, and its detection in neighboring countries, is particularly troubling. Moreover, Clade Ib can spread through physical or direct personal contact, as well as through contaminated bedding or towels.
This is why the WHO made the announcement—it aims to motivate donor agencies and countries to take action. Medical experts emphasized that the declaration should expedite access to testing, vaccines, and therapeutic drugs in the affected regions, as well as initiate campaigns to reduce the stigma associated with the virus.
"The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighboring countries are very worrying. On top of outbreaks of other mpox clades in DRC and other countries in Africa, it’s clear that a coordinated international response is needed to stop these outbreaks and save lives," Adhanom Ghebreyesus said.
Increasing aid to African countries is particularly urgent given that, for example, in the DRC in 2024, children under 15 years old made up 68% of cases and 85% of deaths, according to Africa CDC. Experts suggest this might be due to differences in their immune systems, with high rates of malnutrition making children more susceptible to infections.
What About Preventive Measures?
The two vaccines currently used against mpox are recommended by the WHO, but there are access issues. Africa CDC has claimed it needs 10 million doses, but only 200,000 are available. The response is also being hindered by a lack of treatments and diagnostics.
“Despite a safe and effective vaccine and antiviral treatment against mpox, these are not readily available to most African Union member states,” Africa CDC said.
However, last week, the WHO Director-General initiated the process for Emergency Use Listing of mpox vaccines. This will speed up vaccine access for lower-income countries that haven't yet issued their own national regulatory approval. Emergency Use Listing also allows partners like Gavi and UNICEF to procure and distribute vaccines.