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.

Problems galore

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.

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