As mpox cases in Congo show signs of stabilization, health officials warn that a more robust vaccination campaign is essential to combat the virus and prevent potential outbreaks. Recent reports indicate a decline in weekly lab-confirmed cases from nearly 400 in July to about 200 to 300 now, particularly in Kamituga, where the more infectious variant first emerged. However, only a fraction of suspected cases are being tested, and with ongoing transmission in several regions, experts emphasize the urgency of addressing the vaccine shortage in a country with a population of 110 million.
Despite the encouraging trend, the U.N. health agency acknowledged that only 40% to 50% of suspected cases in Congo are being tested, with the virus continuing to spread in several regions, including Uganda. While doctors are optimistic about the decrease in infections, the specific factors driving the outbreak remain unclear. Health experts are frustrated by the limited vaccine supply available in Congo, which has received only 265,000 doses. So far, WHO estimates that about 50,000 people have been vaccinated in a country with a population of 110 million.
Experts emphasize the urgent need for a comprehensive vaccination campaign across Africa to curb the spread of mpox and prevent further concerning genetic mutations. Dr. Zakary Rhissa, head of operations for the charity Alima in Congo, warned that failure to address the situation could significantly increase the risk of another major outbreak. To date, Africa has reported around 43,000 suspected cases this year, with more than 1,000 deaths, primarily in Congo.
The decline in cases in Kamituga, initially a hotspot for transmission among sex workers and miners, presents an opportunity to enhance vaccination efforts, surveillance, and education. Georgette Hamuli, an 18-year-old sex worker in Goma, highlighted her newfound awareness of mpox after immunization teams visited her neighborhood. She noted the importance of condom use but acknowledged that some clients refuse, complicating efforts to reduce transmission.
The Africa Centers for Disease Control and Prevention estimates that Congo requires at least 3 million mpox vaccines to effectively curb the virus, with an additional 7 million needed for the rest of the continent. So far, WHO and partners have allocated 900,000 vaccines to nine African nations affected by mpox, with an expectation of 6 million vaccines available by the end of the year.
Mpox outbreaks in Burundi, Kenya, Rwanda, and Uganda have roots in Congo, and cases in travelers have also been identified in Sweden, Thailand, Germany, India, and Britain. Heather Kerr, Congo director for the International Rescue Committee, expressed concern that fewer than half of those at highest risk in Congo have been vaccinated, noting the lack of doses for children.
Vaccines for Congo are largely supplied by donor countries, including the U.S., and through UNICEF, which relies on taxpayer funds for procurement. Dr. Chris Beyrer, director of the Global Health Institute at Duke University, criticized the charitable approach that results in limited vaccine donations, calling for a public health strategy to immunize populations at scale.
Bavarian Nordic, the manufacturer of the widely used mpox vaccine, announced it would offer doses intended for Africa at the lowest possible price. However, advocacy group Public Citizen reported that UNICEF paid $65 per dose for the Jynneos mpox vaccine, a price considerably higher than most other vaccines used in public health programs.
Dr. Salim Abdool Karim, an infectious diseases expert at the University of KwaZulu-Natal in South Africa, noted that mpox outbreaks typically peak and subside quickly. However, he identified two complicating factors this time: the virus’s transmission through sexual contact and ongoing spillover from infected animals. “We’re in new territory with mpox this time,” he stated, emphasizing the critical need for widespread vaccination to effectively address the crisis.
