Hope on the Horizon: Mpox Cases in Congo May Be Stabilizing, but Urgent Action Needed

*GOMA, Congo* — Health officials are cautiously optimistic as reports indicate that mpox cases in the Democratic Republic of Congo may be "stabilizing." This development comes following the World Health Organization's (WHO) emergency declaration regarding the outbreak back in August, a move that raised awareness of the ongoing public health crisis.

In recent weeks, Congo has seen a consistent drop in new mpox cases, with weekly lab-confirmed instances ranging from 200 to 300—down from nearly 400 cases recorded in July. This downward trend is notably observed in Kamituga, the eastern mining city where a highly infectious variant of mpox first gained traction.

However, the WHO has expressed concerns about the testing rates in the country, indicating that only 40% to 50% of suspected infections are being analyzed. Moreover, the virus persists in several regions, underscoring the necessity for increased vigilance. Uganda is also facing challenges as it deals with ongoing cases linked to the outbreak.

Despite the positive news regarding case reductions, key health professionals have voiced frustration over the limited vaccine supply available in Congo—265,000 doses in total. Only 50,000 individuals out of a staggering population of 110 million have been vaccinated. “We need a broader effort to vaccinate the entire continent to effectively curb the virus and prevent dangerous mutations,” emphasized Dr. Zakary Rhissa, a leading health operator in Congo for the charity Alima.

So far in 2023, Africa has recorded approximately 43,000 suspected cases of mpox, with more than 1,000 deaths—predominantly occurring in Congo. Dr. Rhissa highlighted the long-term consequences of past outbreaks, such as the one in Nigeria in 2017, which eventually contributed to a global event in 2022 affecting over 100 countries. "If we fail to act now, the potential for another significant outbreak looms large," he warned.

The situation in Kamituga offers a pivotal moment for intervention, particularly among vulnerable populations, including sex workers and miners who were among the initial groups affected. Georgette Hamuli, an 18-year-old sex worker, shared that she only recently learned about mpox when vaccination teams began outreach in her area. “Knowing we are at high risk has changed my perspective on the need for protection,” she remarked, highlighting the importance of educating at-risk communities.

Current estimations suggest that Congo requires a staggering 3 million mpox vaccine doses to curb the outbreak effectively—this only covers the local need, while an additional 7 million doses are essential for the rest of Africa. So far, the WHO has facilitated the allocation of 900,000 vaccines to nine African nations, with expectations for 6 million more by year's end.

After recent epidemics in Burundi, Kenya, Rwanda, and Uganda, many of the mpox cases identified globally—such as in Sweden, Thailand, Germany, India, and the UK—trace back to Congo, exemplifying the interconnected nature of this outbreak. With less than half of the most at-risk individuals vaccinated, the urgency for a comprehensive vaccination campaign cannot be overstated.

Heather Kerr, director for the International Rescue Committee in Congo, emphasized the inadequacy of current vaccine supplies, particularly for children who remain unvaccinated. The majority of the vaccines are sourced from donor nations such as the U.S. and via UNICEF, raising concerns about reliance on charitable contributions rather than a robust public health strategy.

U.S.-based drug manufacturer Bavarian Nordic, creator of the most commonly administered mpox vaccine, stated that they are committed to providing the vaccine to Africa at the lowest possible price. Nevertheless, an analysis by Public Citizen revealed that UNICEF is paying around $65 per dose for Bavarian Nordic's Jynneos vaccine, considerably higher than many other vaccines utilized in public health initiatives.

Experts warn that mpox typically has cyclic outbreaks; however, this time, the virus’s transmission dynamics—particularly via sexual contact and potential spillover from infected animals—introduce new complexities. Dr. Salim Abdool Karim, a leading infectious disease specialist in South Africa, asserts that "until we achieve widespread vaccination, we cannot fully address the challenges posed by mpox."

As the situation unfolds, the global community’s response will be pivotal in determining not just the fate of Congo, but also that of multiple countries grappling with the threat of mpox. Immediate action is crucial to ensure that history does not repeat itself in a worst-case scenario that could lead to another devastating global outbreak.