The 2022-23 global mpox epidemic occurred despite repeated calls from African researchers for increased global investment in mpox diagnostics, therapeutics and infection prevention tools.<\/p>\n\n\n\n
The WHO has now declared a global emergency for the current mpox outbreak in central Africa. This is the highest level of alert for events that pose a risk to the public health of other countries and require a coordinated international response.<\/p>\n\n\n\n
However, the recent story of Mpox is yet another reminder that an infectious disease in one corner of the world should not be seen as someone else’s problem, as it can suddenly begin to spread quickly and far.<\/p>\n\n\n\n
It also highlights global disparities in resource allocation and access to vaccines, diagnosis and treatments. These were made available in many industrialized countries and helped contain the Covid-19 pandemic, but are still largely lacking in most of Africa.<\/p>\n\n\n
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The 2022 outbreak: the ultimate surprise<\/strong><\/p>\n\n\n\n The disease has been renamed ‘mpox’, but the name of the virus, for now, remains ‘monkeypox’ (MPXV). It is closely related to the smallpox virus.<\/p>\n\n\n\n MPXV was considered a zoonosis endemic to parts of central and western Africa. It was mainly acquired through close contact with wild mammals, particularly through the consumption of wild game meat, but there was no sustained human-to-human transmission.<\/p>\n\n\n\n Only very occasionally have cases been observed outside endemic areas, due to infected travelers or the introduction of infected small mammals.<\/p>\n\n\n\n This changed abruptly in 2022: a massive, rapidly evolving global epidemic caused over 99,000 laboratory-confirmed cases in 116 countries. At its peak in August 2022, over 6,000 cases were reported every week.<\/p>\n\n\n\n This outbreak came as a total surprise: most cases were reported from non-endemic areas, mainly in men who have sex with men, who had been infected during recent sexual contact.<\/p>\n\n\n\n Although most of the cases were not clinically very serious and the death toll is just over 200, the WHO, on 23 July 2022, declared a state of emergency.<\/p>\n\n\n\n Fortunately, the number of cases soon plummeted, due to a combination of behavioral changes and vaccination of at-risk groups. Modern vaccines and antiviral drugs with activity against mpox have become available in many affected high-income countries.<\/p>\n\n\n\n These had been developed and stored in the US and Europe, primarily in preparation for a possible biological weapon attack using a plague virus.<\/p>\n\n\n\n The resurgence in Africa<\/strong><\/p>\n\n\n\n The African region is experiencing an outbreak of mpox that began in 2023.<\/p>\n\n\n\n As a continent that includes areas where mpox has long been endemic, Africa now presents a complex mosaic:<\/p>\n\n\n\n Outbreaks derived from the endemic, largely zoonotic, pattern that prevailed in the past. Shocks linked to the 2022 global epidemic, for example in South Africa.<\/p>\n\n\n\n Most alarming is the increasing number of MPXV class Ib infections reported from the Democratic Republic of the Congo.<\/p>\n\n\n\n Already, this outbreak has led to smallpox outbreaks in several neighboring countries of the Congo, including some (such as Kenya) where smallpox cases had never been recorded before.<\/p>\n\n\n\n At the same time, the first case in Europe was detected in Sweden, while a case was also recorded in Pakistan.<\/p>\n\n\n\n