Africa: Cross Border Movement, Poor Response Capacity Drivers of Mpox Spread - Africa CDC

The agency also noted that many African countries are highly vulnerable to mpox infection due to widespread malnutrition and the prevalence of HIV.

The Africa CDC says controlling the spread of Mpox will require immediate action on the continent as the risk of spread between neighbouring countries and globally is high.

Cross-border movement, low public understanding of Mpox transmission, and insufficient response capacity are major challenges among African countries that make the spread likely, according to the public health body.

In an article published on its website, Africa CDC highlighted the vaccine shortage as a serious threat to the countries' efforts at containment.

The agency also noted that many African countries are highly vulnerable to Mpox infection due to widespread malnutrition and the prevalence of HIV.

"The outbreak is further complicated by a high case fatality rate of over 3·9 per cent, particularly among children younger than 15 years, who account for 60 per cent of cases," the agency said.

The agency reported that investigation revealed that heterosexual sexual activities, particularly among sex workers in Congo, are a major driver of Mpox transmission.

This is in contrast with what is obtainable in Europe, where spread occurred mostly between men who had sex with men.

"The high prevalence among women raises concerns about vertical transmission risks and adverse pregnancy outcomes.

"The high risk of severe infection among people living with HIV, considerations for asymptomatic infections, poor vaccination strategies, limited access to medical countermeasures, and low detection rates were other concerns," the agency said.

Rapid spread

On 13 August, the Africa CDC declared Mpox a public health emergency of continental security (PHECS) in Africa.

The agency said it acted in line with its mandate to address significant public health threats.

"This mandate was established in July 2022 by the Executive Council of the Africa Union (AU) Assembly through its decision."

It said the worsening mpox situation on the continent drove the decision.

Between 2022 and now, about 40 874 cases and 1512 deaths have been reported across 15 African Union member states.

In 2024 alone, 17 541 cases and 517 deaths have been reported from 13 AU member states. This shows that there was a 160 per cent increase in cases and a 19 per cent rise in deaths in 2024 compared to the same period in 2023.

In 2023, there was a 79 per cent increase in cases compared to 2022.

The Democratic Republic of the Congo (DRC) accounts for 96 per cent of all cases and 97 per cent of all deaths reported in 2024.

Mpox vaccine production in Africa

Also, the public health agency is currently in talks with Bavarian Nordic, the sole global producer of a mpox vaccine, about transferring technology to enable African manufacturers to produce the vaccine locally.

Africa CDC Director General Dr Jean Kaseya, on Tuesday, said the goal is to have 10 million doses available by the end of 2025.

He described this as a longer-term solution to the Mpox outbreak affecting African countries in West and Central Africa.

"More immediately, the continent expects donations from wealthier countries during this emergency humanitarian era," he said.

He noted that the European Union is assisting with procuring 215,000 vaccines for mpox.

He also appealed to the international community not to impose travel bans on countries dealing with an outbreak of mpox, but instead to support the continent in rolling out testing and vaccinations.

"Don't punish Africa. We hear from here and there that you want to apply travel bans... we need solidarity, we need you to provide appropriate support, this vaccine is expensive," he said.

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