The ongoing mpox outbreak, declared a Public Health Emergency of Continental Security (PHECS) by Africa CDC on August 13, 2024, and a Public Health Emergency of International Concern (PHEIC) by the World Health Organization (WHO) the following day, has impacted 19 African nations. Over 12,000 confirmed cases have been reported this year, with the Democratic Republic of the Congo (DRC) and Burundi being hardest hit.

Testing limitations have hindered effective case management and contact tracing, essential tools for curbing the outbreak. In response, Africa CDC and WHO launched a joint plan to expand testing through scaling up centralised Polymerase Chain Reaction (PCR) sites, activating additional labs, and deploying near point-of-care testing, alongside personnel training and supply distribution.

HE Dr Jean Kaseya, Africa CDC’s Director General, lauded Singapore’s contribution, commenting that for the first time, a comprehensive continental response plan has been developed to address outbreak response pillars, including diagnostics and genome sequencing.

Singapore’s Minister for Health, Ong Ye Kung, stressed the importance of global collaboration. He said that Singapore’s contribution to helping African nations manage the mpox outbreak, is also strengthening global health security, which isa shared international responsibility.

This decision follows the recommendations of an Emergency Committee of independent experts, who met earlier to review data from WHO experts and affected countries. The Committee assessed that the rising mpox cases in the DRC and neighboring countries pose a significant risk of international spread.

In his statement, Dr. Tedros expressed serious concern over the emergence of a new clade of the virus in eastern DRC and its spread to several neighboring countries, emphasizing the need for a coordinated international response to prevent further escalation. “The emergence of a new clade of mpox, its rapid spread in eastern DRC, and the reporting of cases in several neighbouring 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,” he said.

The WHO Regional Director for Africa, Dr. Matshidiso Moeti, highlighted the efforts underway to curb the spread of mpox, stating that “significant efforts are already underway in close collaboration with communities and governments. With the growing spread of the virus, we’re scaling up further through coordinated international action to support countries to bring the outbreaks to an end.”

Professor Dimie Ogoina, Chair of the Emergency Committee, underscored the urgency of the situation, stating that the current upsurge of mpox, especially the sexually transmissible strain, is an emergency for both Africa and the globe. “Mpox, originating in Africa, was neglected there and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself,” he said.

Mpox, caused by the Orthopoxvirus, was first identified in humans in 1970 in the DRC and has been endemic in central and west Africa. A new strain, clade 1b, emerged last year and is spreading through sexual networks. It has been detected in Burundi, Kenya, Rwanda, and Uganda, with over 100 confirmed cases this past month, though the actual number may be higher due to untested cases. The disease has been a growing concern in the DRC for over a decade, with over 15,600 cases and 537 deaths reported last year. Different clades have emerged in various countries, each with distinct transmission modes and risks.

Global response, vax efforts

In response to the outbreak, the WHO has recommended two vaccines currently in use for mpox, which have been approved by WHO-listed national regulatory authorities and individual countries, including Nigeria and the DRC. Last week, Dr. Tedros initiated the Emergency Use Listing process for these vaccines, aiming to expedite vaccine access for lower-income countries that have yet to issue national regulatory approvals. This listing will also enable organizations like Gavi and UNICEF to procure vaccines for distribution.

The WHO is working closely with countries and vaccine manufacturers on potential vaccine donations. It is also coordinating with partners through the interim Medical Countermeasures Network to ensure equitable access to vaccines, therapeutics, diagnostics, and other critical tools.

To support surveillance, preparedness, and response activities, WHO anticipates an immediate funding requirement of US$ 15 million. An initial US$ 1.45 million has been released from the WHO Contingency Fund for Emergencies, with the possibility of further releases in the coming days. The organization is appealing to donors to meet the funding needs for the mpox response.

Source: WHO