In a notable public health development, a comprehensive analysis of the 2024–2025 mpox upsurge in Africa underscores the complex interaction between infectious disease control, political instability, and global health equity. Despite unprecedented joint efforts by the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC), deep-rooted issues continue to hinder progress.

The epicenter of the Public Health Crisis

On 13 August 2024, the Africa CDC declared mpox a Public Health Emergency of Continental Security, followed the next day by a WHO declaration of a Public Health Emergency of International Concern. These declarations followed a rapid increase in cases in the Democratic Republic of the Congo (DRC), with geographic spread to Burundi, Kenya, Uganda, and Rwanda. The emergence of new monkeypox virus (MPXV) variants, particularly clade 1b, has intensified concerns about the ability to contain the disease.

"Controlling mpox in Africa will require more than medical countermeasures; it will demand sustained peace-building efforts, strengthened local health systems, and a global solidarity framework that prioritises those at the greatest risk," researchers articulated in a recent BMJ Global Health commentary.

PersistentChallenges

Armed conflict remains a major driver of uncontrolled transmission. The advance of rebel fighters in Eastern DRC led to the closure or severe limitation of hospital operations, disrupting contact tracing and reducing case detection. Funding shortfalls have compounded these difficulties, with the suspension of certain foreign aid programs exacerbating the resource gap needed for a sustained response. While diagnostic capacity has expanded dramatically—from two laboratories in late 2023 to 23 across 12 provinces—laboratory confirmation remains suboptimal, with only about 51% of clinically suspected cases confirmed through testing.

FutureRamifications

A significant breakthrough occurred with the signing of a ceasefire agreement between the Government of the DRC and the M23 rebel group. Negotiated ceasefire periods could provide critical windows for vaccination and testing campaigns in insecure areas. Furthermore, Africa CDC’s recent approval of the first locally manufactured mpox PCR test in Africa marks a significant milestone in the continent's efforts to achieve self-sufficiency in outbreak diagnostics. Without sustained commitments to peace-building and equitable resource distribution, mpox may remain an enduring example of how neglect prolongs epidemics that could otherwise be contained.