Africa is taking a multi-faceted approach to stemming the mpox epidemic. Credit: FREEPIK
By Aimable Twahirwa
ADDIS ABABA, Sep 12 2024 – As the mpox virus continues to spread to new countries across Africa, triggering a continental health emergency, health authorities are sparing no effort in taking targeted measures to control the outbreak—and have called on funders to ensure that resources are distributed fairly.
Mpox (formally known as monkeypox) was declared a global health emergency by the World Health Organization (WHO) and Africa CDC on August 14 after the new strain, known as clade Ib, began to proliferate from the DRC to neighboring African countries, including Rwanda.
On September 6, the Africa CDC and WHO announced the launch of the Mpox Strategic Preparedness and Response Plan, a joint continental response plan for Africa to support countries’ efforts to curb the spread of the virus to save and protect lives.
Africa Centers for Disease Control and Prevention’s (Africa CDC) director general, Jean Kaseya, said at the launch that this “unified strategy ensures that all partners are aligned on common objectives, eliminating duplication and maximizing impact.”
The overall estimated budget for the six-month plan, running from September 2024 to February 2025, is close to USD 600 million, with 55 percent allocated to mpox response in 14 affected AU Member States and readiness for 15 other Member States, while 45 percent is directed towards operational and technical support through partners.
“This is an important milestone for a coordinated action between our agencies to support countries by reinforcing expertise and mobilizing resources and capacities to swiftly and effectively halt the spread of mpox,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa. “By coming together, we can achieve more, and our collective strength will carry us further, ensuring that communities and individuals are protected from the threat of this virus.”
Mpox cases in Africa have increased at an unprecedented rate over the past three years. In addition to zoonosis-linked outbreaks, the intensified human-to-human transmission through sexual behaviors and other factors requires urgent attention and an enhanced response, according to the Africa CDC and WHO.
To address the ongoing mpox outbreaks, a comprehensive strategy is critical for effective management and mitigation.
It also needs equitable access to resources.
Africa CDC welcomed the Governing Board of the Pandemic Fund’s recent statement on funding, in which it agreed to fast-track support to countries affected by the crisis and to develop a special financing mechanism to support countries experiencing public health emergencies—but with a caveat.
“Africa CDC acknowledges and profoundly appreciates its continued support in strengthening pandemic prevention, preparedness, and response capacities across the continent,” it said, but it also called for “speed and efficiency in garnering resources for mpox, as well as the creation of a special financing mechanism to accelerate support for outbreaks, including mpox.”
Africa CDC and other health organizations on the continent are acutely aware that the playing field is often not even.
“It is the ardent desire and hope of Africa CDC that this transformative upcoming funding round will prioritize a more inclusive approach, increasing support to a greater number of African countries and regional entities, especially in light of the limited allocation in the previous round, where only five (5) of the fifty-five (55) African nations received funding,” it said in a statement released on September 11, calling for an end to delays in the interests of ensuring that health and lives of African populations are safeguarded and prevent the further spread of mpox.
“Together, we have the opportunity to avoid the repetition of past mistakes and build a more just and equitable global health architecture.”
The Mpox Strategic Preparedness and Response Plan emphasizes a community-centered, multisectoral approach tailored to the unique epidemiology and risk profiles of each member state. The plan bolsters surveillance, laboratory testing, and community engagement and ensures the availability of critical countermeasures while building resilient and equitable health systems.
Data from the Africa CDC indicates that there have been 37,583 cases and 1,451 deaths—affecting at least 15 African Union States, including Benin, Burundi, Cameroon, the Central African Republic (CAR), Congo, the Democratic Republic of Congo (DRC), Egypt, Ghana, Liberia, Morocco, Mozambique, Nigeria, Rwanda, Sudan and South Africa.
Health professionals consider a mutated strain of clade I, a type of mpox that spreads through contact with infected animals and has been endemic in the DRC for decades, to be the strain of greatest concern.
Kaseya said during the recent press briefing in Addis Ababa, Ethiopia, that the continental health organization was currently moving towards securing almost 1 million doses of the MX vaccine.
Africa CDC and United Nations Children’s Fund (UNICEF) announced on September 5 that the first shipment of 99,100 doses of the JYNNEOS mpox vaccine had arrived. This shipment is expected to launch a critical vaccination campaign aimed at curbing the rising epidemic in the DRC, the Africa CDC said in a statement.
On September 10, a further shipment of 15,460 doses of the mpox vaccine arrived in the DRC, donated to Gavi-eligible nations by the vaccine producer Bavarian Nordic. They add to the 215,000 vaccine doses that the European Union donated.
One major shortcoming often highlighted is that behaviors are directly implicated in accelerating the spread of mpox, impeding the behavioral change by people who already face challenges in accessing healthcare services in remote communities in Africa.
Prof. Jean Jacques Muyembe, a prominent African epidemiologist from the DRC who is also senior advisor to the Africa CDC’s director general, told IPS that for the specific case of his home country, mpox continues to spread through contaminated bushmeat, which a large part of local communities consume in quantities.
“Adopting and maintaining healthy behaviors is important for these communities where notable zoonotic diseases such as mpox are believed to be transmitted through bushmeat,” said Muyembe, who is also the chair of the DRC’s National Institute for Biomedical Research (INRB).
According to the findings released by the WHO, mpox can spread from animals to people in a few ways, such as through small wild animals in West and Central Africa, where the disease is endemic or with direct close contact with an infected animal, fluids or waste, or getting bitten or scratched.
While bushmeat in most parts of sub-Saharan Africa where mpox is endemic cannot be simply wished away, Muyembe points out that the administration of lifesaving vaccines to hundreds of millions of affected communities remains the best solution for Africa to defeat the outbreak.
“Randomized controlled trials will help us to measure the effectiveness of these health interventions,” said Muyembe.
Apart from bush meats, initial investigations conducted by the Africa CDC in the DR Congo and research elsewhere in Europe suggest that vulnerable populations, like sex workers and men who have sex with men, may be at risk.
“Well-organized standard care can reduce the mortality rate of mpox in Africa, but education is also critical to sensitize most families using the forest for hunting to abstain from bushmeat and also to practice safe sex,” the senior Congolese epidemiologist told IPS.
Kaseya points out that in addition to surveillance and diagnosis, African vaccine manufacturing seems to offer a promising and sustainable solution as the continent currently works hard to safeguard itself against future pandemics and disease outbreaks—and to ensure delays like the ones African nations faced in receiving COVID-19 vaccines never happen again.
“The only tool [for prevention] we have today in Africa is vaccine but for the diagnostic, we want to ensure that in some countries we move from the current 18 percent of testing up to 80 percent of diagnosed cases,” he said.
Since its inception, polymerase chain reaction (PCR) technology has been widely used in all stages of vaccine product development as a tool to assist in the evaluation of vaccine quality, safety and efficacy, especially in Africa.
“Capacity building is critical to support those who are conducting testing in the field,” Kaseya said of current efforts jointly conducted by Africa CDC and other strategic partners, including Global Fund and GAVI Alliance.
Drawing from the past experience of COVID-19, health experts are concerned about vaccine availability.
“Today with mpox we are in a similar situation (to COVID) where we need to look for vaccines because we don’t manufacture them,” he said.
Danish biotech firm Bavarian Nordic has concluded a deal with Africa CDC to ramp up production of its mpox vaccine and enable its vaccine to be manufactured in Africa in the future.
Through the concluded technology transfer deal, the African pharmaceutical industry will start manufacturing the mpox vaccines, according to Africa CDC officials.
Out of nine existing pharmaceutical industries in Africa, only one factory has the capacity to provide the mpox vaccine, it said.
Prof. Nicaise Ndembi, senior advisor to the Africa CDC’s DG, told IPS that the available evidence indicates that the mpox vaccine remains a safe and effective way to protect against symptomatic infection in high-risk close contacts.
“We need to build on current progress made to ensure that the African region is not left behind in efforts to control the mpox pandemic,” he said.
IPS UN Bureau Report
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