Subscribe
Despite being the epicentre of the mpox outbreak that has infected over 103,000 people across 122 countries since January 2022, the Democratic Republic of Congo (DRC) received its first batch of vaccines on September 5, 2024 — nearly two years after the United States and European nations began stockpiling them following their own cases.
So far, DRC has received 99,000 doses from the European Union, with another 110,000 doses expected soon. However, these figures fall far short of the three million doses officials estimate are needed to bring the outbreak under control. Nigeria, the only other African country to secure vaccines, has managed to receive just 10,000 doses.
The World Health Organization (WHO) has declared mpox a public health emergency twice in the past three years — first between July 2022 and May 2023, due to its rapid spread outside Africa, and again on August 14, 2024, following a surge in cases across Africa, largely driven by mutations in the virus.
The mpox virus is categorised into two main clades: I, endemic in Central Africa, and II, which was previously known as the West African clade. Both have two subclades a and b. Clade IIb drove the 2022 global outbreak. The current spike in cases, however, is largely attributed to the more virulent clade Ib, which spreads through close contact and contaminated surfaces.
Since January 2024, Africa has reported over 3,900 confirmed mpox cases and 52 deaths, with drc accounting for the majority — 3,365 cases and 25 deaths, according to WHO. The official numbers from DRC for 2024 are 19,000 suspected cases and 650 deaths.
The most vulnerable population is children, who make up 62 per cent of the patients. Four out of five deaths have occurred in those under 15 years old. The vaccines currently available are only approved for adults.
Mpox has been endemic in DRC since it was first identified in 1970. Though the country experiences outbreaks almost every year, the current crisis has laid bare deeper issues. “The resurgence of the current epidemic can be attributed to three key factors,” said Sharon Ngandu Binagula from Padiyath Medecity-Hopital du Cinquantenaire in Kinshasa.
First, the relaxation of preventive measures, especially the discontinuation of smallpox vaccinations in 1980 (which offered protection from the virus). Second, in endemic countries like DRC, Nigeria and the Central African Republic, humans are increasingly encroaching on animal habitats. Finally, increased international mobility has facilitated the global spread of the virus.
At a press conference, Dieudonne Mwamba Kazadi, director-general of the National Institute of Public Health (INSP), highlighted how poor access to healthcare has worsened the epidemic. INSP is responsible for the Public Health Emergency Operations Centre, DRC’s epidemic preparedness and response system.
DRC is one of the poorest countries in the world, with over 70 per cent of the population living in extreme poverty, according to the World Bank. In rural areas, where mpox is most prevalent, healthcare facilities are often under-resourced, lacking basic supplies, clean water and reliable electricity.
There is severe stigma associated with mpox patients as the clade II of the virus could be transmitted through sexual contact. According to WHO, many people delay seeking treatment out of fear of judgment, further fuelling the virus’s spread.
Ongoing conflict in the eastern provinces, particularly in North and South Kivu, has exacerbated the mpox outbreak. Refugee camps in conflict-torn provinces, where millions live in overcrowded and unsanitary conditions, have become hotspots for the virus. According to Al Jazeera news, armed groups, such as the M23 rebel faction, have made it nearly impossible for healthcare workers to operate in these regions. Vaccine distribution will also be extremely difficult in conflict zones, said Jean Kaseya, directorgeneral of Africa Centers for Disease Control and Prevention (CDC).
Despite the first human case being reported in 1970, the global spotlight only intensified in 2022 when cases of mpox were reported in Europe and North America. This inaction for almost five decades allowed mpox to grow into a global scare.
Not much has changed even now. On September 6, the Africa cdc and who launched a continent-wide response plan to combat mpox. The six-month plan, with a budget of nearly $600 million, aims to bolster the response in 14 affected nations and improve readiness in 15 others. However, funding for this initiative remains uncertain.