As the World Health Organization (WHO) triggered its highest level of alert (“public health emergency of international concern”) on August 14, 2024 in response to the spread of Mpox, also known as monkeypox, we take stock of this disease — known since the 1970s — and its epidemic which remains a concern in Africa.

Why is the epidemic accelerating?

For many years, small, localized outbreaks regularly occurred in Central and West Africa, with some countries like the DRC, Nigeria, Liberia, and Cameroon being endemic areas for the virus. But it was in 2022 that the WHO declared the epidemic a global health emergency after more than 75 non-endemic countries, including the United States, Australia, Canada, and much of Europe, reported cases.

The spread of Mpox quickly subsided in Western countries, but it has taken another turn in recent months in Africa where the two known strains of the virus (clade 1 and clade 2) have continued to circulate, prompting the WHO to trigger its highest level of alert.It is a disease that has evolved and is no longer only transmissible from animals to humans." explains Dr. Jean Kaseya,Director General of the African Centres for Disease Control and Prevention (Africa CDC).

The Democratic Republic of Congo, which currently accounts for 96% of reported Mpox cases, is thus facing a much more virulent strain called clade 1b, more transmissible and more lethal than clade 2, which was responsible for the 2022 epidemic in many Western countries. The virus has mutated and is now transmitted "from human to human, through secretions and contact, with objects used by an infected person such as clothes, a bed, a chair…" explains Dr. Kaseya.Studies are being conducted because we also suspect airborne transmission." he explains.

Sweden and Pakistan have announced the discovery of their first cases of Mpox stemming from the clade 1b variant, thus observed forthe first time outside of Africa. « This variant is spreading very rapidly and is reaching African countries that had never seen it before, such as Rwanda, Kenya, and Burundi. We are seeing many cases in Burundi and Uganda, and these are countries with a lot of contact with the rest of the world. Therefore, it poses a threat to the rest of the world.», explained World Health Organization spokeswoman Margaret Harris.It is likely that other imported cases of clade 1 be registered in the European region in the coming days and weeks" the UN organization also warned.

WHAT IS MPOX?

Formerly known as “monkeypox”, the virus was renamed Mpox by the WHO in 2022.

• It belongs to the genus Orthopoxvirus, like smallpox, but has little to do with monkeys: this name comes from the fact that it was first isolated in primates in the laboratory.

• Transmission occurs primarily from rodents, not monkeys, to humans (zoonosis).

THE VIRUS CLADES

Several "types" (clades) of Mpox are now distinguished, with different dynamics:

• Clade 1: historically present in the Congo Basin (Central Africa).

• Clade 2: more associated with the global outbreak observed in 2022 (during the epidemic outside of Africa).

• Clade 1b: a new strain detected in recent years, which appears to spread through networks of close contact, including sexual contact. The Africa CDC and WHO report that clade 1b plays a central role in the current epidemic.

• Clade 1a: more recently, researchers have highlighted a variant of clade 1a in the DRC, carrying an APOBEC3 mutation, which could make the virus more transmissible.

WHY THIS EPIDEMIC IS WORSENING IN AFRICA

Emergency declaration

In August 2024, the WHO declared the Mpox epidemic in Africa a Public Health Emergency of International Concern (PHEIC), due to the spread of clade 1 (and especially 1b) in several countries.

Geographic spread

Since late 2023 / early 2024, the virus has spread to several countries beyond the DRC (the main focus), including Burundi, Kenya, Uganda, Tanzania, Zambia, and others.

Coordinated response

In April 2025, the WHO and the Africa CDC updated their continental response plan: the objective is both to control current outbreaks, expand vaccination, and put in place a longer-term response.

Improved monitoring

Some African countries have strengthened their surveillance (case detection, testing, prevention): according to the WHO, since October 2024 several nations (Republic of Congo, Gabon, Guinea, South Africa…) have moved into the “control phase” (no new cases for several weeks).

Charge in DRC

Despite efforts, the Democratic Republic of Congo remains the most affected country: it accounted for nearly 80% of confirmed cases in the region according to a WHO report at the end of 2024.

Funding and logistical challenges

The response plan requires significant resources: according to the Africa CDC and the WHO, more than USD 220 million has been mobilized or is needed to fill gaps, particularly for vaccination and the integration of Mpox into regular health services.

Alert status remains in effect

In July 2025, the WHO's International Emergency Committee (Health Regulations) reassessed the situation: it judged that the Mpox epidemic continues to represent a USPPI.

WHAT ARE THE SYMPTOMS AND HOW CAN YOU PROTECT YOURSELF?

Mpox causes painful skin lesions, often on the skin and mucous membranes, as well as fever, headaches, body aches, fatigue, and swollen lymph nodes.

• Transmission occurs mainly through close contact: skin-to-skin, mucous membranes or via contaminated objects.

• The “zoonosis” component (animal → human) remains important, but the spread between humans (person to person) has intensified, particularly in family or community settings.

After an incubation period of six days to three weeks, the first symptoms are general and resemble those of the flu: fever, muscle aches, headaches, fatigue... Skin lesions then appear, which can sometimes be painful and leave scars, butWith the emergence of new strains, there are now also cases where skin lesions appear before general symptoms" explains Dr. Jean Kaseya.

Recovery generally occurs within two to four weeks, but to protect oneself from the virus, for which there is currently no known cure, the most effective measure remains maintaining good personal hygiene and washing hands regularly. People with multiple sexual partners should also be particularly vigilant, as the virus is known to be transmitted through close contact.

Challenges and risks

• The discovery of the “highly transmissible” variant 1a (with the APOBEC3 mutation) is raising concerns because it could make the virus more contagious, although the mortality linked to this variant is not yet well established.

• Health systems in several African countries remain fragile, and access to care, testing and vaccines is a major challenge.

• There is an urgent need for a strong international commitment: funding, sharing of vaccines, strengthening of local capacities for surveillance and care.

The Mpox epidemic in Africa is not “just a comeback”: it presents new challenges, with more transmissible strains, wider spread, and longer-term response needs. The WHO declaration in 2024 and the updated strategies in 2025 demonstrate the scale of the threat and the commitment to strengthening the response. However, progress must continue: vaccinating, monitoring, providing care, and mobilizing sustainable resources.

MPOX: AN INCREASINGLY DANGEROUS VIRUS IN AFRICA

The Mpox epidemic (formerly known as “monkeypox”) is raging in Africa, with growing concern about a particularly virulent variant. While the World Health Organization (WHO) declared on August 14, 2024, that the situation constituted apublic health emergency of international concernThe most recent data shows that the threat is not weakening.

A more deadly variant

Until now, Mpox was considered significantly less virulent than smallpox. But the emergence of a new subclade—clade 1b, particularly active in the Democratic Republic of Congo (DRC)—changes everything. According to health authorities, this variant could lead to a much higher mortality rate.

– In the DRC, Clade I is the only one detected to date. – As of May 26, 2024, the WHO reports 7,851 confirmed cases and 384 deaths, representing a case fatality rate (CFR) of 4.9%.

– The Africa CDC indicates, in a report dated July 30, 2024, that across the continent, the number of cases increased by 160% in 2024 compared to 2023, with a CFR of 3.2%.

– Experts even mention a case fatality rate of up to 10% in children in certain contexts related to clade 1b.

The vaccine, the only treatment to stem the epidemic

The vaccines developed to immunize against smallpox are also 80% effective against Mpox, which could allow the epidemic to be brought under control fairly quickly. However, since the WHO announced the eradication of the disease in 1980, vaccination campaigns have been halted, which could partly explain this resurgence of Mpox.Vaccination against smallpox, which provided cross-protection against monkeypox, kept it suppressed for a long time, but people born since the cessation of smallpox vaccination have not been vaccinated, resulting in a larger reservoir of people susceptible to contracting monkeypox. explained in 2022 on RFI the epidemiologist of the Pasteur Institute, Arnaud Fontanet. This is one of the factors that could explain why this virus is starting to circulate more and more. ». 

By declaring its highest level of alert, a "public health emergency of international concern," in 2024, the WHO will be able to prioritize financial resources for the fight against the Mpox virus, despite its tight budget constraints. Nearly $1.5 million has already been released by the WHO from its emergency fund. The organization estimates that its response plan requires at least $15 million in initial funding. The WHO's announcement should also unlock funds for access to vaccines in Africa.

While vaccines against Mpox exist, their availability remains insufficient, particularly in Africa. The African Union's health agency, Africa CDC, announced that some 200,000 doses have been deployed in Africa. This initiative is supported by the European Union (EU) and the Danish manufacturer Bavarian Nordic, which has stated its capacity to produce an additional two million doses by the end of 2024 and up to ten million by the end of 2025.

This situation further underscores the urgent need for Africa to achieve vaccine independence.We are told that there is currently a stockpile of 200,000 doses of vaccines worldwide, while a country like the DRC is already requesting three million. », says Dr. John Kaseya. “ Starting to produce our own vaccines and medicines is, for me, the fight of the century." concludes the director of the Africa CDC.