Mpox cases in Congo appear to be stabilizing, offering a hopeful sign that the country might be managing the virus more effectively. The World Health Organization (WHO) recently noted a decline in reported cases, suggesting that the major epidemic for which they declared a global emergency in August could be waning. However, while cases are decreasing, health officials emphasize that without more vaccines, it will be challenging to completely eradicate the virus.
Current Trends in Mpox Cases
Reports show a drop in confirmed mpox cases in Congo, with around 200 to 300 new infections weekly, a significant decrease from July’s peak of nearly 400 cases. This decline is visible in cities like Kamituga, a mining hub in eastern Congo where a new, more infectious variant initially emerged. WHO estimates that roughly 40-50% of suspected infections in Congo are being tested, highlighting the need for comprehensive surveillance and testing to prevent further spread.
Vaccine Challenges in a Complex Landscape
Despite a promising decline, vaccination efforts face hurdles. Congo has received only 265,000 doses, a small fraction of what’s needed for a nation with 110 million people. Of these, about 50,000 people have been immunized, leaving significant portions of the population at risk. Reaching remote areas in Congo’s vast landscape poses logistical challenges, making it difficult to provide vaccines to those in need.
The Call for Broader Vaccination in Africa
To prevent further spread and the risk of mutations, experts are urging a broader vaccination campaign across Africa. Scientists warn that if this opportunity for wider immunization is missed, there’s a high probability of another major outbreak. The continent has seen over 43,000 suspected cases and more than 1,000 deaths, primarily in Congo, emphasizing the need for a strong response.
Dr. Zakary Rhissa, who manages operations for Alima in Congo, stressed the importance of tackling mpox before it evolves further. He noted how past outbreaks, such as the 2017 epidemic in Nigeria, have set the stage for larger global events, including the widespread 2022 outbreak that impacted over 100 countries.
Understanding Mpox Spread and High-Risk Populations
Mpox primarily spreads through close contact. However, pinpointing exact transmission routes remains difficult, creating challenges in controlling the virus. Health officials are particularly concerned about high-risk groups, including sex workers and miners, who are often more exposed. In Kamituga, where mpox first spread among these groups, local efforts have begun to provide vaccines and educate people about prevention.
Georgette Hamuli, an 18-year-old sex worker in Goma, eastern Congo’s largest city, only learned of mpox when vaccination teams arrived in her neighborhood. She noted that clients sometimes refuse to use protection, despite the health risks involved. Hamuli received her mpox vaccine from a charity organization and expressed relief, saying the vaccine made her feel protected.
Vaccine Shortages and International Aid
To effectively combat the virus, the Africa Centers for Disease Control and Prevention (CDC) estimates that Congo requires at least 3 million doses, with another 7 million needed for the rest of Africa. Yet, vaccine supply remains limited. WHO has allocated around 900,000 doses for African countries hit by mpox, and approximately 6 million additional doses are expected to be available by year’s end. Still, this falls short of the demand, with many at-risk individuals left unprotected.
Heather Kerr, Congo’s director for the International Rescue Committee, mentioned that fewer than half of those at highest risk in Congo have been vaccinated. “We have a very limited vaccine supply, with almost nothing available for children,” she said.
Donor countries, including the United States, have been the primary sources of mpox vaccines for Congo, often working through UNICEF, which purchases the shots mainly using taxpayer funds. However, advocates argue that this charitable approach is insufficient, with Dr. Chris Beyrer, director of Duke University’s Global Health Institute, stressing the need for a public health approach that can immunize at scale.
The High Cost of Mpox Vaccines
Bavarian Nordic, the company manufacturing the widely used mpox vaccine, has committed to offering it at the lowest possible price for Africa. However, Public Citizen, an advocacy group, noted that UNICEF has been paying $65 per dose of Bavarian Nordic’s Jynneos vaccine—substantially higher than prices for other public health vaccines. This high cost limits the number of doses that can be distributed, affecting access in countries where the vaccine is most needed.
Mpox’s Unique Characteristics and Future Concerns
Mpox behaves differently than other viruses, complicating response strategies. Dr. Salim Abdool Karim, an infectious disease expert at the University of KwaZulu-Natal in South Africa, pointed out that while most mpox outbreaks peak and fade quickly, the virus’s spread through sexual transmission and its occasional transmission from animals make this situation particularly complex. This form of transmission requires new approaches to prevention, surveillance, and vaccination.
Unlike measles or influenza, mpox can pass back and forth between humans and animals, allowing it to persist in the environment and giving it more chances to mutate. These characteristics increase the urgency of a widespread vaccination campaign, as each mutation poses a potential risk for a new outbreak.
Looking Ahead: The Need for Sustained Immunization
For the foreseeable future, sustained vaccine distribution will be essential to keeping mpox under control. Experts believe that once immunity is strengthened in high-risk communities, such as mining towns and urban centers, the virus’s reach will diminish. However, achieving this will require the full cooperation of international health organizations, donor countries, and local governments to ensure that vulnerable populations receive the necessary doses.
The WHO continues to monitor mpox in Congo and neighboring countries, while international agencies work to secure additional doses to cover those at risk. Although stabilizing cases are a positive sign, experts caution that without a more substantial, coordinated effort, containment may remain out of reach.