GOMA, Congo — Health officials are reporting signs that the mpox outbreak in Congo might be “stabilizing,” potentially indicating a decline in the epidemic that led the World Health Organization (WHO) to declare a global emergency in August.
Recent data shows that the number of laboratory-confirmed mpox cases in Congo has dropped to around 200 to 300 per week, a decrease from nearly 400 weekly cases reported in July. This downward trend is particularly noticeable in Kamituga, the eastern mining city where a new, more transmissible variant of mpox first surfaced.
However, the WHO has highlighted the fact that only 40% to 50% of suspected infections in the country are being tested. The virus continues to spread in various regions, including Uganda, raising concerns among health officials. Despite the observed decline in some areas, the outbreak’s driving factors remain unclear. Experts are also voicing their frustration over the limited supply of vaccines, with only 265,000 doses received by Congo, a nation of 110 million people. WHO estimates suggest that only around 50,000 individuals have been vaccinated so far.
There’s a pressing need for a more extensive vaccination campaign across the continent to curb the spread of mpox and prevent further mutations. Dr. Zakary Rhissa, who oversees operations in Congo for the humanitarian organization Alima, emphasized that failing to seize this opportunity significantly increases the risk of another major outbreak.
This year alone, Africa has registered approximately 43,000 suspected cases and more than 1,000 fatalities, predominantly in Congo. Dr. Rhissa warned that history shows how outbreaks, like Nigeria’s in 2017, can escalate to larger global crises if not efficiently managed.
The drop in cases in Kamituga, initially linked to sex workers and miners, presents an opportunity to enhance vaccination, surveillance, and educational initiatives. Georgette Hamuli, an 18-year-old sex worker, shared her newfound awareness of mpox after vaccination teams visited her impoverished neighborhood in Goma.
“They informed us about our high risk of infection,” she explained. “While we insist on condom use with clients, many refuse… if they decline, they often offer double the payment.” Hamuli noted that she and her fellow sex workers received 2,000 Congolese francs (about $0.70) from a charity to encourage vaccination, but it was the vaccination itself that motivated her participation.
According to the Africa Centers for Disease Control and Prevention, Congo requires a minimum of 3 million mpox vaccines to combat the outbreak effectively, while an additional 7 million are needed for the rest of the continent. Currently, WHO and its partners have allocated 900,000 doses to nine African nations affected by mpox, with expectations of 6 million vaccines becoming available by the end of the year.
Outbreaks in neighboring countries such as Burundi, Kenya, Rwanda, and Uganda can be traced back to infections originating in Congo. Furthermore, cases related to travel have been found in Sweden, Thailand, Germany, India, and the UK.
Fewer than half of those at highest risk in Congo have received vaccinations. Heather Kerr, the Congo director for the International Rescue Committee, expressed concern about the vaccine shortage and the absence of options for children as well.
Vaccines for Congo primarily come from donor nations like the United States and organizations like UNICEF, which uses taxpayer funds to obtain them. Dr. Chris Beyrer, director of the Global Health Institute at Duke University, criticized the current charity-based approach for its limited impact, stressing the need for a broader public health strategy to immunize populations on a large scale.
Bavarian Nordic, the manufacturer of the leading mpox vaccine, stated they would sell vaccines for Africa at the lowest feasible price. However, advocacy group Public Citizen has noted that UNICEF paid around $65 per dose for the Jynneos mpox vaccine, substantially higher than most other public health vaccines.
Dr. Salim Abdool Karim, an expert in infectious diseases from the University of KwaZulu-Natal in South Africa, noted that while mpox outbreaks usually diminish quickly due to the virus’s transmission method, there are now two complicating factors: the virus’s sexual transmission and the ongoing spillover from infected animals. He remarked, “We are in uncharted territory with mpox this time. But solving the issue depends on vaccinating the majority of our population.”
