Days after the World Health Organization (WHO) declared this summer’s mpox (formerly called monkeypox when discovered in 1958) outbreaks in Africa a global emergency on August 14, Congo is set to receive the first vaccine doses from the U.S. over the next week, the country’s health minister said on August 19.
Mpox cases have been confirmed among children and adults in more than a dozen African countries as well as on other continents in recent days, and a new form of the virus is spreading (details below). Few vaccine doses are available in Africa, making foreign support essential.
Congo has the vast majority of the mpox cases and currently needs three million vaccine doses. The U.S. and Japan have offered to donate vaccines, Health Minister Roger Kamba informed the media.
Kamba did not say how many doses would be sent or when the ones from Japan would arrive.
In an effort to add perspective and minimize media-driven panic, a high-ranking World Health Organization official flatly said, “Mpox is not the new COVID.”
The WHO originally declared the mpox epidemic a global health emergency in July 2022, and the disease was detected in over 70 countries that had never previously reported mpox. Since then, it has affected nearly 100,000 people in 116 countries. Though the 2022 outbreak has largely subsided in Europe, Asia, and the Americas, it has worsened in parts of Africa and the emergence of a new strain (see below) is what has generated a new emergency declaration.
New mpox strains have evolved
It is important to understand that the current emergency is not one mpox outbreak, but in reality, three which are occurring at the same time but affecting distinct groups of people and behaving differently.
They are labelled by their “clade” – a Greek word referring to which branch of the mpox virus family tree they are part of.
Clade 1a is causing most of the infections in the west and north of the Democratic Republic of Congo. This outbreak has been going on for more than a decade and is spread primarily by eating infected wildlife known as bushmeat. Those who get infected can pass the virus onto people they come into close contact with, and children have been particularly affected.
Clade 1b is the new evolution of the mpox family and is causing outbreaks in the east of the DRC and neighbouring countries. This is being spread along trucking routes with drivers having heterosexual sex with exploited sex workers, with infected people also transmitting it to children through close contact.
The WHO labelled Clade 1b as one of the main reasons for it declaring a Public Health Emergency of International Concern. This strain has spread to countries previously unaffected by mpox – Burundi, Kenya, Rwanda, and Uganda.
The WHO says 3.6 percent of known mpox cases died for Clade 1a in 2024 although in previous years the figure was closer to 10 percent. It has no equivalent figure for the new Clade 1b strain.
Clade 2 is the mpox outbreak that went around the world in 2022 and also had a strong connection with sex, this time predominantly affecting gay, bisexual and other men who have sex with male communities (98.6 percent were men in the UK) as well as their close contacts. This outbreak is not over. History suggests Clade 1 outbreaks are more dangerous than Clade 2.
New cases reported out of Africa
Mpox is not expected to be a Covid-level event. It is already nearly a year since the new Clade 1b strain emerged in September 2023. The most likely scenario in the EU and similar countries is somebody flies back with the virus and becomes ill.
These imported cases could be the end of it or there may be limited spread within households through close physical contact. Sweden had the first Clade 1b case outside of Africa, with no further spread reported, with new Clade 1b cases just reported in the Philippines and Pakistan.
Global mobilization
There are still no mpox-specific vaccines, but smallpox vaccines work against the disease and are being deployed, two in particular (the Jynneos vaccine and ACAM2000). Smallpox and the monkeypox viruses are both Orthopoxviruses and immunity to one leads to protection from the other.
Unfortunately, the end of the smallpox immunization campaigns – after the disease was eradicated in 1979 – is one of the reasons the world is seeing mpox take off now. Those who did get a smallpox vaccine as children, despite a now-aged immune system, should still have some protection.
The real fear is the current outbreak could intensify if authorities in Africa can’t get enough of the incoming vaccines through what remains a pretty fragile public health infrastructure in much of the continent.
Foreign Ministry Channel for Global Health Security activated to deal with crisis
The U.S. State Department issued the following media note to describe its recent activity related to mpox and the work of the new foreign ministry (FMC) channel for global health security:
“On August 23, Ambassador Dr. John Nkengasong – U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy – led a special session of the Foreign Ministry Channel for Global Health Security (FMC) to discuss the global response to the unprecedented surge of Clade I mpox cases in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa. On August 14, the World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern following the Africa Centres for Disease Control and Prevention (Africa CDC) declaration of a Public Health Emergency of Continental Security on August 13.
During the special session, WHO’s Dr. Maria van Kerkhove, Africa CDC’s Dr. Ngashi Ngongo, and Dr. Christian Ngandu representing the DRC government provided updates on the mpox situation and their respective roles in supporting the response. Foreign ministry partners shared information and ideas to strengthen international collaboration to prevent the spread of mpox, detect cases, treat those impacted by the virus, and address roadblocks impeding the response. The United States highlighted the importance of timely action to save lives and prevent disease spread, noting that an infectious disease threat anywhere can be a threat everywhere. Representatives from Africa CDC, Australia, Bangladesh, Canada, DRC, the European Union, France, Germany, Japan, Morocco, Norway, Republic of Korea, South Africa, Spain, Sweden, Thailand, the United Kingdom, and WHO attended the session.
State Department and foreign ministry counterparts
