Mpox Outbreak Worsens in Africa: Africa CDC Calls for Coordinated Response as Cases Reach 21,466

The Africa Centres for Disease Control and Prevention (Africa CDC) has issued an urgent call to African health ministers to adopt a comprehensive strategy for diagnosing and managing the growing Mpox outbreak.

In a letter dated August 23, 2024, and signed by Dr Jean Kaseya, the Director-General of Africa CDC, the organisation highlighted the escalating crisis and the need for robust measures to address it.

A Public Health Emergency of Continental Concern

On August 13, 2024, Africa CDC declared Mpox a public health emergency of continental security, underscoring the severity of the outbreak.

The letter from Dr Kaseya provided alarming statistics: from January 1 to August 23, 2024, Africa has reported a total of 21,466 Mpox cases, comprising 3,350 confirmed and 18,116 suspected cases. The outbreak has led to 591 deaths, resulting in a case fatality rate of 2.9 per cent.

The disease has spread across 13 African Union (AU) member states, including Burundi, Cameroon, Central African Republic, Congo, Côte d’Ivoire, Democratic Republic of Congo (DRC), Gabon, Liberia, Kenya, Nigeria, Rwanda, South Africa, and Uganda. Notably, Gabon recently confirmed its first case, while Sierra Leone and Malawi are currently testing suspected cases.

Beyond Laboratory Testing: A Holistic Approach Needed

Dr Kaseya emphasised that a negative laboratory test result does not definitively rule out Mpox, suggesting that over-reliance on testing alone can lead to misdiagnoses. He advocated for a holistic approach that combines laboratory testing with clinical assessments and epidemiological data to provide an accurate diagnosis and effective management of Mpox.

The Africa CDC has consulted with top African and international epidemiologists and laboratory experts, including those from the U.S. CDC, China CDC, Europe CDC, and the World Health Organisation (WHO), to ensure the most effective response strategies are adopted.

Key Challenges in the Fight Against Mpox

Dr Kaseya outlined several challenges that hinder the effective management of the Mpox outbreak:

1. Limited Vaccine Availability: Only three African countries—Nigeria, South Africa, and the DRC—have approved the use of Mpox vaccines. Moreover, the global demand for vaccines, coupled with monopolistic vaccine manufacturing, poses a significant risk of Africa being sidelined in vaccine distribution.
2. Low Domestic Resources: Many member states face challenges in mobilising sufficient domestic resources to combat the outbreak, making them heavily reliant on external support.
3. Public Awareness: Communication strategies to raise public awareness about Mpox and the importance of vaccination have been sub-optimal, reducing the effectiveness of preventive measures.
4. Cross-Border Virus Circulation: The virus’s ability to cross borders threatens previously non-endemic countries, increasing the risk of wider spread.
5. Inadequate Diagnostic Capabilities: Many African countries have insufficient diagnostic capacities, resulting in low testing rates, with some reporting rates as low as 18 per cent. This limitation leads to under-detection and under-reporting of cases.
6. Surveillance Gaps: Weak surveillance systems further exacerbate the problem, allowing the virus to spread undetected and uncontained.

Call for Unity and Action

Dr Kaseya urged African leaders to unite in advocating for equitable access to vaccines and other medical countermeasures. He warned that failure to act decisively could result in Africa being overlooked in global vaccine distribution and potentially facing travel restrictions from Western countries concerned about the spread of Mpox.

Collaborative Efforts to Strengthen Preparedness

To tackle the outbreak, the African Incident Management Team—comprising Africa CDC, WHO, UNICEF, Médecins Sans Frontières (MSF), Coalition for Epidemic Preparedness Innovations (CEPI), Wellcome Trust, and Gavi—will collaborate with all affected countries and those at risk. The goal is to ensure that each country has an updated response and preparedness plan tailored to its specific needs and circumstances.

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