The mpox outbreaks ravaging Africa have illuminated the perilous consequences of decades-long neglect by the international community. The alarming surge in mpox cases across the continent, which led to the World Health Organization’s (WHO) declaration of a global health emergency, serves as a stark reminder of the systemic failures to address and prevent emerging infectious diseases in vulnerable populations. As African scientists and health officials sound the alarm, the world is forced to reckon with the repercussions of its inaction.
The Roots of a Crisis
Mpox, also known as monkeypox, is not a new affliction. For years, it simmered largely unnoticed in remote parts of Africa, overshadowed by more prominent global health threats. But as the disease began to spread beyond Africa’s borders, culminating in a 2022 outbreak that affected over 70 countries, the global health community could no longer afford to ignore it.
Dr. Dimie Ogoina, a leading voice in the fight against mpox and chair of WHO’s mpox emergency committee, has been vocal about the role of negligence in the current crisis. “Negligence has led to a new, more transmissible version of the virus emerging in countries with few resources to stop outbreaks,” Ogoina stated during a recent virtual press conference.
His words points a bitter truth: the global community’s failure to address mpox in its earlier stages has allowed the virus to evolve and spread, leaving Africa, once again, to bear the brunt of a preventable health crisis.
A Disease Largely Ignored
Mpox belongs to the same family of viruses as smallpox but is typically less severe, causing symptoms such as fever, body aches, and in more serious cases, prominent blisters on the face, hands, chest, and genitals. Despite its potential to cause significant harm, especially in vulnerable populations, mpox was largely ignored by the global health community for years. This neglect is now proving costly.
According to Ogoina, mpox had been spreading mostly undetected in Africa for years before it triggered the 2022 global outbreak.
Unlike the 2022 outbreak, which primarily affected gay and bisexual men in Western countries, the current wave in Africa is spreading through broader means of transmission, including sexual contact and close contact among children, pregnant women, and other vulnerable groups.
This shift in transmission patterns highlights the virus’s ability to adapt and thrive in populations with little to no immunity, exacerbating the crisis.
A Young Population at Risk
One of the most significant challenges in combating mpox in Africa is the continent’s demographic profile. With a predominantly young population, Africa lacks the widespread smallpox vaccination coverage that older generations in other parts of the world may benefit from. This leaves the majority of Africa’s population highly susceptible to mpox.
“While most people over 50 were likely vaccinated against smallpox, providing some protection against mpox, this is not the case for Africa’s mostly young population,” Ogoina explained. The implications of this are profound.
As the virus spreads unchecked, the lack of immunity among Africa’s youth amplifies the potential for widespread transmission and severe outcomes, further straining already fragile health systems.
The WHO’s Declaration and the Rising Toll
Earlier this month, the WHO took the unprecedented step of declaring the surging mpox outbreaks in Congo and 11 other African countries a global emergency. This declaration was a sobering acknowledgment of the scale and urgency of the crisis.
The numbers are staggering: according to the Africa Centers for Disease Control and Prevention (Africa CDC), there have been more than 22,800 mpox cases and 622 deaths on the continent, with infections spiking by 200% in the last week alone.
The majority of these cases and deaths have been reported in Congo, where the disease is particularly devastating to children under 15.
Dr. Placide Mbala-Kingebeni, a Congolese scientist who played a crucial role in identifying the newest variant of mpox, has highlighted the challenges in tracking and controlling the spread of the virus.
Diagnostic tests currently used in Congo are not always effective in detecting the variant, complicating efforts to monitor and contain outbreaks. “The noted mutations suggest it was ‘more adapted to human transmission,’ but the lack of tests in Congo and elsewhere complicates efforts to monitor outbreaks,” Mbala-Kingebeni noted.
The Emergence of a New Variant
In May, Mbala-Kingebeni and his team at Congo’s National Institute for Biomedical Research published research on a new form of mpox. This variant, while potentially less deadly, is more transmissible, raising concerns about its capacity to cause widespread outbreaks.
The variant has since been detected in four other African countries and even in Sweden, where health officials reported the first case of a person infected with the more infectious form of mpox after a stay in Africa.
The discovery of this new variant has added a layer of complexity to the already daunting task of controlling mpox in Africa.
The WHO has cautioned that while there is no current evidence to suggest that the new form of mpox is more dangerous, research is ongoing to better understand its characteristics and implications.
The Impact on Vulnerable Populations
The human toll of the mpox outbreaks extends beyond mere numbers. Marion Koopmans, a virologist at Erasmus Medical Centre in the Netherlands, has been studying the effects of mpox on particularly vulnerable groups. “Scientists are now seeing some significant impacts of the disease,” Koopmans said, noting that pregnant women have experienced miscarriages or lost their fetuses, and some babies have been born infected with mpox.
These findings underscore the severe and often overlooked consequences of the disease, particularly in settings with limited access to healthcare and support.
The stigma associated with mpox further exacerbates the suffering of those affected. In many communities, individuals with mpox face social ostracization and discrimination, compounding the physical and emotional toll of the disease.
This stigma is particularly pronounced in cases where mpox is linked to sexual transmission, leading to further marginalization of already vulnerable groups.
The Struggle for Resources
As the mpox crisis deepens, the lack of resources available to African countries to combat the disease has become increasingly apparent. Vaccines and therapeutics, which could provide critical protection and treatment, remain in short supply. Ogoina has emphasized the need for African health workers to focus on providing supportive care in the absence of adequate medical interventions. “It’s very, very unfortunate that we have had mpox for 54 years and we are only now thinking about therapeutics,” he lamented.
Mbala-Kingebeni has suggested that strategies previously used to combat Ebola outbreaks in Africa might offer some guidance in the fight against mpox. One such strategy is “ring vaccination,” where vaccines are administered to people in close contact with an infected person to contain the spread of the virus. However, with Africa needing an estimated 10 million doses of mpox vaccine but only expecting to receive about 500,000 doses, the challenge is immense. “Finding a case and vaccinating around the case, like we did with Ebola, might help us target the hot spots,” Mbala-Kingebeni said.
The Global Response: Too Little, Too Late?
The international community’s response to Africa’s mpox crisis has been, at best, lukewarm. Despite the urgent need for vaccines and medical supplies, global contributions have been limited and slow to materialize. Spain’s recent announcement that it would donate 20% of its mpox vaccine stockpile to African countries — amounting to about 500,000 doses — was a welcome gesture but still falls far short of what is needed. “We consider it senseless to accumulate vaccines where they are not needed,” Spain’s health ministry said in a statement, calling on other European Union member states to follow suit.
The European Union, vaccine manufacturer Bavarian Nordic, and the United States have also pledged vaccines to Africa, though in much smaller quantities.
The U.S. recently donated 10,000 doses of mpox vaccine to Nigeria, marking the first shipment of vaccines to Africa since the WHO declared the global emergency.
Japan has also contributed some doses to Congo. However, these efforts are a drop in the ocean compared to the scale of the crisis.
Marion Koopmans has pointed out the impracticality of waiting for more vaccine doses to be produced while the situation in Africa worsens. “The short-term question really is about, who has vaccines and where are they to be best used next?” she said, emphasizing the need for a more coordinated and timely global response.
The Way Forward
The mpox outbreaks in Africa are a stark reminder of the persistent inequities in global health. As the virus continues to spread and mutate, the consequences of the world’s neglect are becoming increasingly dire. The international community must act swiftly and decisively to support Africa in its fight against mpox, not only by providing vaccines and medical supplies but also by addressing the underlying systemic issues that have allowed the crisis to escalate.
There is a pressing need for increased investment in African health systems, improved access to diagnostic tools, and a commitment to equitable distribution of vaccines and therapeutics. The lessons learned from the mpox outbreaks must serve as a catalyst for change, ensuring that the world is better prepared to prevent and respond to future pandemics.
In the words of Dr. Dimie Ogoina, “What we are witnessing in Africa now is different from the global outbreak in 2022.” Indeed, the mpox crisis in Africa is not just a health emergency; it is a wake-up call to the global community. The time for action is now, before more lives are lost and the opportunity to contain the virus slips away.
