Urgency and Resilience In Africa’s Mpox Response

Just last week, the World Health Organization (WHO) declared that mpox is no longer classified as a Public Health Emergency of International Concern (PHEIC). Global cases have declined significantly since the PHEIC was first declared in August 2024, but ongoing outbreaks across Africa—particularly in the East—suggest that the crisis is far from over. But even in the face of this ongoing challenge, local governments and health organizations are now equipped with the lessons learned from over a year of rapid response efforts. 

So, what have these efforts entailed?  

In July 2024, a new variant of mpox (Clade Ib) spread across East Africa, with the Democratic Republic of Congo (DRC) as the epicenter. Within months, the disease exploded into a full-blown health emergency. Since then, more than 28 African countries have reported mpox outbreaks, with two distinct clades spreading across the continent: Clade Ib in Central and East Africa, and Clade IIb in West Africa. And the toll is staggering: over 174,000 suspected cases and hundreds of deaths have been reported, with the DRC, Sierra Leone, and Kenya some of the hardest-hit countries. 

But while the virus has spread quickly, so too has Africa’s response capacity. New labs, mass vaccination campaigns, and coordinated surveillance efforts are pushing back—even under the burden of conflict, misinformation, and vulnerable health systems. 

Let’s break it down by region. 

The DRC, AKA the ground zero of mpox outbreaks, has trailblazed response efforts. The country leapt into action in expanding diagnostic capabilities; from just two labs at the start of 2024, the DRC is now home to 69 diagnostic laboratories capable of identifying mpox.  

Still, plagued by ongoing conflict and less-than-ideal infrastructure, many suspected cases remain untested both in DRC and throughout Africa. Less than a third of the continent’s reported cases (29,849) and deaths (197) have been lab-confirmed, due largely to continued capacity limitations in the hardest-hit zones. 

Kenya has been facing one of the fastest-growing mpox outbreaks on the continent—but they’re fighting back. The country is launching a mass vaccination campaign focusing on the highest-risk populations, such as health workers and immunocompromised individuals, in Mombasa, Busia, and Nakuru counties.  

The country has reported 370 confirmed cases since July 2024—but 157 of these occurred in the last two months, meaning the outbreak is growing and a rapid response is needed. 

About 10,700 doses of a third-generation mpox vaccine were delivered to Kenya earlier this year with support from Gavi, Africa CDC, and WHO. But this is just a drop in the bucket.  

Overall, despite supply issues and funding changes, over 886,000 people have been vaccinated on the African continent since the PHEIC was declared. According to African health officials, the U.S. government has authorized the shipment of another 219,000 mpox vaccines (as of August 21, 2025), although it is unclear when they will be shipped. Rapid response and coordination are critical to maintain the progress made thus far, with the overall number of confirmed cases down 70% since the year’s peak.  

Sierra Leone has recorded over 5,000 cases and 47 deaths since its first confirmed case in December 2024. At the peak of the outbreak in May, the country was reporting over 100 new cases every day, accounting for 75% of all mpox cases in Africa at the time and pushing health systems to their brink.  

Sierra Leone’s early strategy focused on home isolation. However, when it became clear that this was not containing the virus, the government pivoted: more than 1,000 treatment beds were activated, and all positive cases transferred to these designated facilities. This strategy, paired with expanded vaccination and public outreach, has helped bring down case numbers significantly.  

The continent’s response has been coordinated through a joint Incident Management Support Team, led by Africa CDC and WHO, which has trained over 3,000 health workers across Africa, facilitated vaccine distribution in 12 countries, and enabled cross-border cooperation between countries like Kenya, Uganda, and Rwanda.  

In terms of priorities going forwards, expanded surveillance, especially in high-risk communities and border regions to detect new cases before they can spread; integrating health services, such as doubling down on the health infrastructure against mpox for other diseases, like rapidly-spreading cholera; and combating stigma, as memories of episodes like Ebola continue to fuel fear and resistance in some areas, will all be crucial.  

Mpox in Africa is far from over, but the continent has made undeniable progress in confronting a virus that has evolved quickly. Countries like Sierra Leone, Kenya, and the DRC have shown the simultaneous vulnerability and resilience of Africa’s public health systems. Mpox is a regional threat with global implications; the virus could surge again under the right conditions if containment fails in Africa. Global coordination and continued investment are more important than ever.  

The fight is ongoing—but Africa is not fighting unprepared.