Mpox, a viral zoonotic disease formerly known as monkeypox, has emerged as a significant public health concern in several African countries. While the disease is not new to the continent, its increasing frequency and expanded geographic spread have put public health systems and communities to the test. As African countries work to control outbreaks, there is hope that they can manage the disease effectively with proper interventions. However, several impediments persist, which complicate efforts to halt its spread.
Current landscape of mpox in Africa
Mpox was first identified in humans in 1970 in the Democratic Republic of the Congo (DRC) and is endemic in several Central and West African countries, including Nigeria, Cameroon, and the Central African Republic. It primarily affects animals such as rodents and monkeys, with humans becoming infected through direct contact with infected animals or their bodily fluids. Human-to-human transmission can also occur, particularly in crowded settings where close contact is common.
In 2022, mpox gained global attention as it spread to non-endemic countries, particularly in Europe and North America. However, the disease’s continued presence in Africa remains a critical issue. The World Health Organisation (WHO) has consistently raised alarms about the growing number of cases in the region, with countries like Nigeria, the DRC, and the Central African Republic reporting periodic outbreaks. Despite its relatively low mortality rate, mpox can cause severe health complications, especially in children and immunocompromised individuals. The following offer some hope in the management of the disease in Africa.
Improved surveillance and early detection
One of the major hopes for successfully managing mpox outbreaks is the improvement of surveillance and early detection systems across Africa. Countries like Nigeria have made substantial progress in this area by increasing the training of health workers, improving diagnostic capacity, and strengthening epidemiological tracking systems. Additionally, partnerships with international health organisations such as the WHO and the Centres for Disease Control and Prevention (CDC) have facilitated knowledge sharing and technical support.
Increased access to vaccination
Another promising intervention in the fight against mpox is the availability of vaccines. Vaccines for mpox, such as the smallpox vaccine (which provides some cross-protection), have been used to combat outbreaks in endemic regions. There is growing hope that expanding access to mpox vaccines, particularly in areas with high rates of transmission, could drastically reduce the incidence of the disease. For instance, in response to rising cases, some countries have introduced mass vaccination campaigns targeted at at-risk populations such as healthcare workers and people in close contact with infected animals.
Stronger regional collaboration
Regional cooperation is another key hope in managing mpox outbreaks across Africa. The establishment of the Africa Centres for Disease Control and Prevention (Africa CDC) has provided a platform for African countries to share data, resources, and best practices. Collaborative efforts in managing infectious diseases, such as Ebola and cholera, have proven to be effective and could be replicated in the fight against mpox. While there are several reasons to be hopeful, managing mpox in Africa is fraught with the following challenges that hinder effective control efforts.
Inadequate healthcare infrastructure
A major impediment to effectively managing mpox outbreaks in Africa is the region’s inadequate healthcare infrastructure. Many African countries face chronic shortages of medical supplies, diagnostic tools, and trained healthcare personnel. This lack of resources severely limits the ability to detect, isolate, and treat cases of mpox in a timely manner. Rural areas, where access to healthcare is particularly limited, are especially vulnerable to outbreaks.
Public misinformation and stigma
Misinformation and stigma surrounding infectious diseases pose significant challenges in controlling outbreaks. In the case of mpox, misinformation can lead to delays in seeking medical care, as individuals may not recognize the symptoms or may fear being ostracised due to the stigma associated with the disease. This, in turn, can increase the risk of human-to-human transmission as infected individuals may continue to interact with others.
Stigma surrounding mpox may also stem from the misconception that the disease is exclusively associated with certain behaviours or groups of people, leading to discrimination and further complicating public health efforts. Addressing these issues through public education campaigns and community engagement is crucial in improving response efforts.
Limited funding and political will
Finally, inadequate funding and political will remain significant obstacles. Although some international organisations and governments have provided financial support, many African countries still struggle with limited budgets allocated to public health initiatives. This lack of funding hampers efforts to scale up vaccination programs, improve healthcare infrastructure, and fund necessary research into new treatments or vaccines for mpox. Political instability and shifting priorities in some regions also contribute to a lack of sustained attention to mpox, making it difficult to implement long-term strategies.
