The Mpox Insights & Actions: Making Sense of Mpox Trackers highlights actionable insights based on analysis of key trackers and provides priority recommendations for effective and timely outbreak responses.
Oct. 29, 2024 Update
Editorial Note: The following PAN analysis is current as of Oct. 29, 2024, and based on mpox tracker data from: WHO (Updated Oct. 26, 2024), Africa CDC Mpox Briefing (Updated Oct. 24, 2024), IPPS (Updated Oct. 13, 2024), and Think Global Health (Updated Oct. 22, 2024)
PRIORITY RECOMMENDATIONS
- Targeted, community-centered efforts for mpox vaccination and other interventions. More focus is needed to make sure interventions — from vaccines to infection prevention and control (IPC) — reach the most at-risk and vulnerable populations, including children. This will require purposeful and scaled-up efforts for community engagement with high-risk groups to co-design effective outreach strategies. Efforts must be taken to ensure campaigns are tailored to address specific concerns, counteract misinformation, and provide clear, accessible information on the risks, safety procedures, and vaccination benefits.
- Double down on non-vaccine interventions to curb the spread of mpox in vulnerable communities and high-risk settings. Focus and funding for the many other interventions that can help curb the spread of mpox at the community level is urgently needed, tailored to meet the needs of the most at-risk and vulnerable. This includes increased access to diagnostics; water, sanitation, and hygiene interventions; and scaled up efforts to work with communities to understand their needs and prevent the spread of infection.
- Increase transparency and information-sharing on total mpox response funding, and vaccine need, access, and delivery. All efforts must be taken to safely, responsibly, and equitably advance the approval and introduction of novel mpox countermeasures — especially sorely lacking diagnostics and therapeutics — and technologies designed for use in low-resource settings. This will require not only proactive communications on medical countermeasures in the pipeline and coordination to streamline Emergency Use Authorization/Emergency Use Licensing/Pre Qualification, but also proactive outreach to affected communities to build relationships, trust, and mutual understanding ahead of any rollout.
SITUATION
2024 Outbreak
- 18 countries on the African continent have reported 9,320 confirmed mpox cases as of Oct. 29. Children under 15 account for 38.1% of the confirmed cases.
- Four countries — Cameroon, Gabon, Guinea, and South Africa — have not reported confirmed cases in the last six weeks and are considered to have transitioned into the mpox outbreak’s control phase.
- Uganda reported its first mpox death on Oct. 23 and is now ranked third among African countries with the highest confirmed case counts, surpassing Nigeria.
- In total, the continent has seen a 400% increase in confirmed mpox cases in 2024 compared to the whole of 2023. Confirmed cases in the Democratic Republic of the Congo (DRC) — the outbreak’s epicenter — have reached 7,534.
- There is a coinciding increase in mpox and measles cases among the under 15-age group in the DRC.
Response
- Only 5.3% of the 5.39 million vaccine doses pledged have arrived in Africa to-date.
- Three DRC provinces — Nord Kivu, Sud Kivu, and Tshopo — have been vaccinating for three weeks, achieving or even exceeding initial coverage rate targets with 138.5%, 109.3%, and 91.7%, respectively.
- DRC’s capital city, Kinshasa, is scheduled to begin vaccinations on Nov. 8.
- Vaccination efforts have started in DRC prisons and internally displaced persons (IDP) camps.
- There are no vaccines approved for children under 12 available on the African continent to date.
- The average weekly testing rate across the African continent has risen by 37% over the past three weeks.
- Seven sets of sequencing equipment and maintenance support have been provided to Burundi, Ethiopia, Kenya, Mauritania, Sierra Leone, and Zimbabwe through the Africa CDC.
- 7,000 Gene Xpert machines and cartridges from the Africa CDC and WHO have been distributed to Burundi, Cameroon, Central African Republic, Congo, Côte d’Ivoire, DRC, Kenya, Liberia, Rwanda, and Zambia, along with 11,000 qPCR tests.
ANALYSIS
The mpox response in Africa is showing some signs of progress with four countries reporting no new confirmed cases for several weeks and given new access to equipment and testing. The increase in average testing rates per week across the continent highlights increased capacities in and commitment to surveillance. However, despite advancements, there is still an urgent need for increased infection, prevention, and control interventions.
The rise in mpox cases in Uganda is concerning and highlights the need for enhanced surveillance, preventive actions, and prompt interventions to control the outbreak within the country. Regional and global partners must strengthen efforts to partner with Uganda to help bolster capacities in disease prevention, control, and response to address this surge.
The vaccine campaign in DRC is showing promising results, especially the extension to high-risk settings like prisons and IDP camps to reach vulnerable populations often overlooked in outbreak responses. However, vaccines are just one part of an effective and equitable response. IPC and water, sanitation, and hygiene (WASH) measures remain critical to curb transmission, particularly in settings where crowding and sanitation issues heighten infection risk.
Concurrent infections of mpox and measles in children under 15 in North and South Kivu present a serious public health concern that requires attention and study to investigate potential shared sources of infection. Strengthening IPC measures in hospitals is essential to prevent facility-based transmissions, which could be exacerbating both outbreaks. This also highlights the urgent need to expedite the approval of safe vaccines for children under 12 to help ensure that this vulnerable group is adequately protected against mpox.