By Michael Gwarisa
While Mpox cases have been on a downward trend in most World Health Organisation (WHO) regions, the same cannot be said for Africa as cases have been increasing every month since the beginning of 2024.
With over 99,000 laboratory-confirmed cases, and 208 deaths having been confirmed globally since January 2024, the total number of cases reported in 12 African countries as of August 18, 2024, according to the WHO Afro Region is 4,562 and 35 lab-confirmed deaths. WHO has since declared Mpox a Public Health Emergency of International Concern (PHEIC).
Despite efforts by health bodies and governments, the region is currently saddled with numerous challenges that could derail the Mpox response if action is not taken soon. These include a lack of understanding of the epidemiology in terms of transmission dynamics in all countries, incomplete data, delayed reporting, poor contact tracing, lack of cross-border information sharing, and poor testing levels in some countries.
Speaking during a virtual Joint WHO-Africa CDC Briefing on the Mpox Situation in Africa, WHO Afro Regional Adviser, Country Readiness Strengthening, Dr Charles Njuguna said Mpox presents the region with numerous opportunities for collaboration.
We know that diseases don’t need Visas to jump from one country to another one and already Mpox has the potential to spread to other member states through cross border and also international travel. Even the picture that we see at the moment is not the full picture. We are lagging behind in terms of data collection and laboratory testing. We need to see how best we can do cross-border surveillance, collaboration and information sharing,” said Dr Njuguna.
He added that collaborating on case investigation and contact tracing is very important and called on countries to work together as partners to do joint readiness and response planning, coordination and partnerships to ensure that even those countries that are not affected at the moment are ready to deal with the Mpox in case they report cases.
“There is also an opportunity for joint advocacy and resource mobilisation efforts. We are aware that currently in terms of Mpox response, we have serious limitations in terms of resources that are available.”
He also said there is need to integrate the One-health Approach in the Mpox response since the disease is Zoonotic in nature.
Mpox has to date affected several African countries. However, Epidemiological distribution and transmission dynamics vary according to country with data showing that in the DRC, transmission is being driven by human to human-to-human contact and potential zoonotic transmission, particularly in rural areas for example Northern, Western and Eastern DRC. In Burundi, infections are dispersed across various regions with no significant clustering observed.
The proximity of cases in Burundi to the DRC border suggests potential cross-border transmission. In Uganda, cases are confined to the area bordering the DRC also indicating cross border transmission. In South Africa, its m, mainly human-to-human transmission within specific high-risk populations and infections are concentrated among Men who have Sex with Men (MSM) and individuals with underlying conditions.
Dr Michel Muteba an Epidemiologist with WHO Afro Region said there is a need to address resources constraints in the Mpox response.
“There are so many challenges facing the Mpox response, especially the stigma that we face on the ground and people not sharing information of the contacts. The big challenge is the one regarding resources and also the competing priorities that we have in the region. We have financial and logistical challenges to the Mpox response,” said Dr Muteba.
He added that the region was experiencing a limited introduction of vaccine therapeutics but hopes things will change since the Public Health Emergency of International Concern (PHEIC) has been declared.
“We have limited funding for specific IPC activities regionaly and also also at country levels in countries where the preparedness and readiness need to be normally on top of the game.”
He added that the data received from countries is incomplete at times and there is delayed responses due to accessibility challenges.
The African region has recorded Mpox outbreaks even though most cases were confined to the Democratic Republic of Congo (DRC). The new outbreak being driven by a highly infectious strain, the clade Ib variant has pushed the virus beyond usual borders.
The African Epidemiological trend is showing that the number of cases from January 2024 has been increasing monthly even though no death have been reported over the past two months. The DRC has been the most affected country having recorded 16, 123 suspected cases, 1888 confirmed cases and 558 potential deaths related to Mpox and eight confirmed according to WHO.
“This year I would like to say we have new countries that have recorded cases but had never presented cases before and these are Rwanda, Uganda, Kenya, Burundi and Ivory Cost. In week 32 over 1000 new suspected cases and 27 potential Mpox deaths have been reported in the DRc
All these countries have reported cases linked to Clad 1d which originated from the Eastern Parts of the DRC. Clad 1a is dominant in the Northern Part of the DRC is mostly affecting Children below the age of 15.
