Illustration: Liu Rui/GT
Due to the rapid spread of monkeypox (mpox) in the Democratic Republic of the Congo and its surrounding countries,
the Africa Centres for Disease Control and Prevention (Africa CDC) on August 13 declared mpox a public health emergency of continental security. The following day, the World Health Organization (WHO) declared mpox a public health emergency of international concern (PHEIC), urging a coordinated international response.
This is the second time WHO has declared mpox a PHEIC in two years.
Compared to the previous outbreak, the current one is much larger in scope and severer, requiring more complex and challenging responses at both national and international levels.
This time, researchers discovered it was a new lineage of the virus, which they called "clade Ib," distinct from previously known mpox strains. It follows a significantly different transmission pattern compared to the previously known "clade II." The clade Ib strain has reportedly mutated to become more efficient at human-to-human transmission.
On August 16, European Centre for Disease Prevention and Control (ECDC) said it is highly likely that the EU/EEA will see more imported cases of mpox currently circulating in Africa, and recommended that EU/EEA member states issue travel advice for people visiting or returning from areas affected by the outbreak. On August 19, the Philippines announced that it detected one new mpox case, the first in the country this year.
From a national response perspective, African countries continue to grapple with long-standing issues such as weak public health systems and the high cost of vaccines. The Democratic Republic of the Congo faces particularly severe challenges: complex security conditions, a fragile public health infrastructure, and limited resources for testing, treatment and care.
The country has also experienced frequent outbreaks of major infectious diseases like Ebola and cholera in recent years. Some studies indicate that cases of mpox in the Democratic Republic of the Congo may have been detected in as early as September 2023. Following this, the virus rapidly spread to most provinces within the country and even crossed national borders.
Moreover, as with previous global public health crises, significant challenges remain in vaccine supply and access. On August 20, WHO stressed that Europe can defeat mpox, and must support Africa in getting vaccines. Africa CDC estimates the continent needs 10 million doses of mpox vaccine to combat the current outbreak. But now, only about 200,000 are available.
MVA-BN, or Modified Vaccinia Ankara-Bavarian Nordic, is the only mpox vaccine approved in the US, Switzerland, Canada, the EU/EEA and the UK. But its price is far beyond what African countries can afford.
Even if efforts to purchase vaccines internationally and collaborate on their production manage to address some of the supply problems, implementing vaccination campaigns on the ground remains a significant challenge.
From the perspective of international organizations, in June, the World Health Assembly agreement reached a package of amendments to improve the International Health Regulations, which will strengthen global preparedness, surveillance and responses to public health emergencies, including pandemics. The amendments have not yet officially taken effect.
Reports show that the WHO anticipates an immediate funding requirement of $15 million to support surveillance, preparedness and response activities in this round of mpox outbreak. So far, the WHO has released $1.45 million from its contingency fund for emergencies.
For the international community, effectively responding to this mpox outbreak and preventing the escalation of risks remains a daunting task. In the context of increasingly interconnected global health, it is crucial to increase support for affected countries in Africa, and swiftly curb the outbreak at its source.
Addressing the necessary measures involves not only ensuring access to vaccines and treatments for African countries but also enhancing local testing and monitoring capabilities, improving healthcare services, disseminating public health information, promoting behavioral changes and providing economic and social support. Only through a comprehensive approach can we effectively contain the spread of the current mpox outbreak.
Countries must normalize the prevention and response to outbreaks and continuously strengthen their public health systems to prevent future crises and achieve the ambitious goal of building a global health community.
The author is a professor at the School of International Relations and Public Affairs at Shanghai International Studies University. [email protected]
