Unraveling the Heartbreaking Reality

Dr. Elin Hoffman Dahl can’t shake the image of one Mpox patient from her mind—his body covered in heartbreaking lesions, making even basic activities like eating and walking an agonizing challenge. ‘He was a beautiful person,’ she recalls, as he desperately requested a mirror. Witnessing his suffering left a profound impact on her.

Mpox: A Mild Virus or a Lethal Threat?

To many, Mpox may seem like a mild virus that resolves on its own. However, in Sierra Leone, where Dr. Dahl was deployed by Médecins Sans Frontières (MSF), the situation is dire—untreated HIV transforms this virus into a potential death sentence.

Discovery of a Hidden Epidemic

The epidemic of Mpox that began in January 2023 has brought to light a staggering public health crisis: untreated HIV is far more prevalent than official stats claim. While the nation celebrates its Mpox response as a success, the alarming rates of HIV uncovered in patients reveal a hidden epidemic that demands urgent attention.

Impact of Aid Cuts on Health Initiatives

The fallout from former President Trump’s cuts to foreign aid has compounded the crisis. Activists argue that weakened programs have stymied the nation's response capabilities, leaving communities vulnerable and lacking the resources they desperately need.

Staggering Levels of HIV in Patients

When Dr. Dahl arrived in Sierra Leone, she collaborated with local experts accustomed to infectious disease management. Yet, even they were taken aback by seeing HIV rates among Mpox patients soaring well beyond the national average of 1.7%. Many suffered from undiagnosed HIV, while others had previously been diagnosed but were not receiving treatment—a stigma that looms large, preventing individuals from seeking the care they need.

Surviving the Storm: The Urgency of Treatment

For those living with untreated HIV, the complications of Mpox can be catastrophic. With proper antiretroviral therapy, individuals can live relatively normal lives. However, untreated patients find themselves at extreme risk. Dr. Dahl explains, ‘The goal becomes to start people on HIV medications to help rescue their immune systems.’ Unfortunately, for some, like the patient she recounted, this effort proved too late.

Community Response and the Need for Funding

James Riak Mathiang, program manager for humanitarian organization GOAL Sierra Leone, emphasizes the connection between tackling Mpox and addressing the HIV crisis. Until the Mpox epidemic is controlled, discussions surrounding HIV treatment remain stagnant. The loss of flexible funding from USAID has further hampered the ability to respond effectively, leaving a critical gap in public health resources.

Local Leadership Emerging in Crisis Response

While Sierra Leone’s response to the current outbreak has been celebrated, it hasn’t come without challenges. There were delays in mobilizing resources and engaging traditional leaders for community support. Nevertheless, Dr. Mohamed Bella Jalloh notes a positive shift towards more African-led initiatives in managing these outbreaks, marking a turning point in local leadership.

The Ongoing Challenge Ahead

Despite significant advancements, the country continues to fight the Mpox outbreak, with aspirations to achieve zero cases. However, as Dr. Jalloh poignantly remarks, ‘This won’t be the last outbreak we see.’ Aid dependency discussions are ongoing, and the recent budget cuts have ignited a sense of urgency to redefine more self-sufficient health strategies.

A Call to Action

The lessons learned from Sierra Leone’s struggles with Mpox and HIV highlight an urgent need for global support and adaptive local leadership. As the nation pushes forward, it’s clear: aid shouldn’t dictate our health agendas, and the time for sustainable change is now.