Mpox Outbreak in Africa Risks Becoming the Next Global Pandemic

Africa’s Neglected Outbreak Threatens Global Health

The unpredictability of infectious diseases, mpox, once dismissed as a distant problem affecting impoverished regions, now threatens to spiral into a global crisis. Discovered in 1958 and first reported in humans in 1970, this disease was largely ignored by the scientific and public health communities for decades, relegated to the status of an exotic oddity confined to the remote corners of Africa.

But what was once considered a footnote in the annals of medical research has suddenly exploded onto the global stage. The 2022-23 outbreak, which saw over 99,000 cases spread across 116 countries, was a wake-up call. For the first time, this so-called “monkeypox” — now officially renamed “mpox” — demanded urgent attention from researchers and health officials worldwide.

The outbreak primarily hit developed nations, raising alarm among high-income countries and forcing an unprecedented surge in research and funding.

Yet, as the dust of the global crisis seemed to settle, complacency took hold. The World Health Organization’s declaration of mpox as a public health emergency of international concern in July 2022 was a stark indicator of the threat level. However, despite the initial outcry, the global response has been lukewarm, particularly when it comes to addressing the disease’s resurgence in Africa.

Now, as the disease re-emerges with renewed ferocity, Africa is at the epicenter of a potential global health disaster. The Democratic Republic of Congo (DRC), a region already beleaguered by conflict, natural disasters, and other infectious diseases, is witnessing a disturbing rise in mpox cases.

The newly emerged MPXV clade Ib, a more virulent strain than the previously dominant clade II, is spreading with alarming speed. This clade is marked by a higher case fatality rate and displays mutations that facilitate human-to-human transmission — a significant departure from its historical zoonotic pattern.

The current outbreak, particularly in South Kivu province, is more than a regional crisis; it has the potential to spark a global pandemic. The disease is now exhibiting sustained human-to-human transmission, often through sexual routes, with increased transmissibility and a higher mortality rate. The failure of commonly used tests to detect this new strain only complicates the situation, leaving many cases uncounted and unchecked.

The unsettling reality is that while high-income countries had access to vaccines and treatments developed in anticipation of a poxvirus bioweapon, many African nations remain woefully under prepared. The disparity in global health resources is glaring, with essential tools for combating mpox still out of reach for the countries most affected. The outbreak’s progression in Africa underscores a profound inequity in health resource allocation and preparedness.

As mpox cases spread to neighboring countries like Kenya — previously untouched by the disease — the urgency for a coordinated global response becomes undeniable. There’s an immediate need for equitable access to diagnostic tests, vaccines, and antiviral treatments. The establishment of an African-led Mpox Research Consortium (MpoxReC) is proposed as a crucial step towards combating this crisis. This consortium would drive research into the disease’s transmission, clinical manifestations, and the development of effective interventions.

The global health community must confront its own failures head-on. Neglecting diseases in poorer regions not only endangers those directly affected but also sets the stage for outbreaks that can quickly escalate into global emergencies. Mpox’s rapid transformation from a regional concern to a global threat is a stark warning that infectious diseases do not respect borders.

The world’s response to mpox must be as dynamic and comprehensive as the disease’s potential to spread. Ignoring or downplaying the risks of neglected diseases is no longer an option. As we stand on the brink of what could be the next pandemic, it’s time for the global health system to wake up and address the deep-seated inequities that allow such crises to fester unchecked. The clock is ticking, and the stakes couldn’t be higher.