The global mpox outbreak continues to pose significant public health challenges, particularly in Africa. The World Health Organization (WHO) has maintained the classification of the outbreak as a Public Health Emergency of International Concern (PHEIC), underscoring the persistent threat of the disease.
Mpox, formerly known as monkeypox, is a viral zoonotic disease characterized by flu-like symptoms and a distinctive rash. While typically self-limiting, certain strains have exhibited higher transmissibility and severity. The current outbreak, which began in September 2023 in the Democratic Republic of the Congo (DRC), involves a novel variant known as clade Ib. This strain has led to a substantial increase in cases and fatalities, with over 29,000 suspected cases and more than 800 deaths reported since January 2024.
The DRC has been the epicenter of this outbreak, facing compounded challenges due to ongoing conflicts. The advancement of Rwanda-backed M23 rebels in eastern regions has severely disrupted healthcare services. Key hospitals have lost their capacity to detect and treat mpox, exacerbated by the destruction of facilities, shortages of medical supplies, and the displacement of patients. This turmoil hampers efforts to track and prevent the spread of the disease, with health authorities negotiating for humanitarian corridors to deliver essential aid.
Complicating the situation further, a highly contagious mutant strain of mpox has been identified in the DRC. This new clade 1a variant carries mutations associated with increased transmissibility, raising significant concerns among health officials. Although higher fatality rates have not been observed, the potential for rapid spread necessitates heightened surveillance and response efforts.
The outbreak has not been confined to the DRC. Neighboring countries such as Burundi, Kenya, Rwanda, and Uganda reported their first mpox infections of the new clade in July 2024. By January 2025, Sierra Leone declared a health emergency following the confirmation of multiple mpox cases within a short span. These developments highlight the virus’s capacity for regional spread, particularly in areas with porous borders and limited healthcare infrastructure.
Internationally, cases of clade Ib mpox have been detected beyond Africa. In August 2024, Sweden reported the first case outside the continent, involving an individual who had traveled to an affected African region. Subsequently, countries including Germany, Ireland, and the United Kingdom have reported imported cases linked to travel from Africa. For instance, in January 2025, the UK Health Security Agency confirmed a case in London involving a patient who had recently returned from Uganda, where community transmission of the variant is ongoing.
The response to the outbreak has been hampered by geopolitical factors. The dismantling of the U.S. Agency for International Development (USAID) and the cessation of global public health funding by the Trump administration have raised concerns about the capacity to manage the mpox crisis effectively. Experts warn that reduced humanitarian aid could lead to more severe global health emergencies, as regions previously reliant on such assistance become increasingly vulnerable.
Despite these challenges, there are indications that the outbreak may begin to plateau. The Africa Centres for Disease Control and Prevention (Africa CDC) anticipates that while cases may continue to rise in the short term, they could stabilize by early next year. However, this projection hinges on the effectiveness of response efforts, including surveillance, vaccination campaigns, and public health interventions.
In conclusion, the multi-country mpox outbreak remains a pressing global health issue. The emergence of more transmissible strains, coupled with geopolitical and infrastructural challenges, underscores the need for coordinated international efforts. Strengthening healthcare systems, ensuring the availability of medical supplies, and maintaining robust surveillance are critical to controlling the spread of mpox and mitigating its impact on affected populations.
