Africa declares monkeypox a continental emergency. Will this change anything?

In response to new and recurring outbreaks of swine fever in several African countries, the Africa Centers for Disease Control and Prevention Declared African swine fever became a continent-wide public health emergency on Tuesday. Although many countries outside Africa quickly controlled the outbreak that began in 2022large outbreaks continue unabated in West and Central Africa. Now, a more deadly strain is spreading across Africa’s borders.

Monkeypox, formerly known as monkeypox, is an infectious disease closely related to but far less severe than smallpox, and is suspected to have originated in African rodents and non-human primates. Acne Interest rate differential Through close contact with an infected person, including sexual contact and skin-to-skin contact. Pregnant women can also pass the virus to their babies during pregnancy and after delivery. symptom The symptom of MPOX is a blister-like rash that usually lasts two to four weeks. Other symptoms include fever, fatigue, muscle aches, cough and sore throat.

For decadesmpox has caused sporadic cases and outbreaks in Nigeria, the Democratic Republic of the Congo, and several other African countries. Main strains mpox: Clade Iwhich causes more severe disease and has historically been confined to Central Africa, and clade II, which has historically caused infections in West Africa.

exist May 2022Countries outside Africa suddenly began to record cases of MPOX caused by type II B-linked strains. In July of that year, the World Health Organization declared the epidemic a public health emergency of international concern. By May 2023, more than 100 countries Nearly 90,000 cases of mpox have been documented, and 150 deaths.

Fortunately, public health agencies around the world acted quickly to improve disease surveillance, raise awareness among high-risk groups, especially men who have sex with men, and Encouraging Safe sex. In the United States and Europe, there were 30,000 and 25,000 cases of mpox, respectively, between May 2022 and May 2023, and officials also spread million As a result, MPox transmission has declined rapidly in most countries. May 2023The World Health Organization has lifted its state of emergency.

Today, while the MPOX outbreak is not currently considered an international health emergency, the outbreak is still ongoing and cases are still being reported in countries around the world. According to one study, in June 2024, 175 cases were reported in North, Central, and South America; 100 cases were reported in Europe, and 11 cases were reported in Southeast Asian countries. Situation Report Published by the World Health Organization.

But as the global burden of MPOX improves, outbreak The epidemic in the Democratic Republic of Congo in Central Africa is worsening. Unlike other parts of the world, the DRC is infected with the most severe strain of MPox in the world. Clade IAs of May 2024, 7,851 The country has reported mpox cases and 384 deaths.

In the past two months, Four East African countries African countries such as Burundi, Kenya, Rwanda and Uganda reported their first cases of MPox type I, sparking fears that a deadlier MPox pandemic could be imminent. Other African countries are also facing a resurgence of MPox caused by type II viruses. In May, a total of 465 All African countries have recorded cases of swine fever, totaling 567 in June, an increase of 22%.

The increase in African swine fever cases has prompted the Africa CDC to declare the disease a public health emergency on the continent. mechanism This is the first time the African Union, which represents 55 African countries, has designated the outbreak a continental emergency.

“We are declaring today a public health emergency for the security of the African continent in order to mobilize our institutions, our collective will and our resources to act swiftly and decisively,” Africa CDC Director Jean Kaseya said at a press conference on Tuesday.

But the response in the Democratic Republic of Congo and other African countries is once again hampered by the same challenges that health officials have faced during previous outbreaks and pandemics. Including Covid: Lack of global solidarity and reluctance to share life-saving resources. Although vaccine doses were quickly distributed in the United States and Europe in 2022, vaccines are only now beginning to flow into the Democratic Republic of the Congo. But even so, there are only a few hundred thousand vaccines for a population of more than 10 million. 100 million people.

Governments and multinational organizations such as the African Union are slowly working to promote domestic public health infrastructure and technical capacity, and reduce reliance on donor countries. While the Africa CDC’s unprecedented designation of the MPOX outbreak as a regional health emergency signals a continuation of these efforts, it is unclear whether the designation will help stimulate the rapid influx of resources needed to respond to the MPOX outbreak.

Mpox was first discovered in 1958 The first case of mpox was discovered in a 9-month-old baby in a group of monkeys at a Danish research facility. 1970 In the Democratic Republic of Congo. Researchers and doctors can uncertain how the infant became infected; however, close contact with infected monkeys may have led to infection. Small rodents, monkeys, and mammals Can be Viruses are not contagious to humans, but outbreaks usually occur when people infect each other.

In 2005, more cases of human infection with MPOX were recorded in the Democratic Republic of Congo, with thousands of suspected cases reported each year since then. Since 2017, MPOX has also caused frequent infections in Nigeria.

Although MPOX has been around for a long time, there are still many unknowns about how the virus spreads and why it suddenly spread across the globe in 2022. What researchers do know is that the virus has been mutating rapidly in recent years.

Interestingly, and perhaps worryingly, while most mutations have no effect at all, some may cause the virus to become more deadly or spread more efficiently. When geneticists compared the 2022 mpox genome with samples collected in 2017, they found that Establishment Some 40 Genetics mutation It has already happened. Some researchers suggestion These mutations have improved how easily the virus spreads between people, but there does not seem to be definitive evidence yet. consensus However.

In September 2023, a new mpox clade I variant (tentatively called clade IB) was discovered Discover Democratic Republic of Congo. The World Health Organization has not yet confirmed whether the new variant causes more severe illness or is more easily spread.

Rosamund Lewis, the technical lead for MPox at the World Health Organization, doesn’t think a genetic mutation is responsible for the sudden global surge in MPox. Instead, she thinks the virus just happened to start infecting new groups of people — sex workers and men who have sex with men — which in turn fueled wider transmission. MPox is reminiscent of the origins of HIV, when chimpanzee After infecting humans in southwestern Cameroon root In the booming urban centre of Kinshasa, the capital of the Democratic Republic of Congo, and where a large number of sex workers gather.

Sexual transmission between adults may be only one of the main drivers of mpox transmission. 70% 90% of the MPox cases recorded this year have been in children, who may have been infected through close contact with infected animals or infected family members.

One of the greatest risk factors for severe MPOX infection and die is pre-existing HIV infectionUnfortunately, 25.6 million Africans infected with HIV More The African swine fever outbreak is worse than in any other region of the world, which means that many African countries are likely to experience a more deadly outbreak than other parts of the world. The dual burden of African swine fever and HIV is also a major factor that prompted the Africa CDC to declare the African swine fever outbreak a continental emergency, Cassia explained.

At least one vaccine is available. Giniosalso known as Ivanix In Europe, the drug is effective against MPOX. The U.S. Food and Drug Administration Officially recognized 2019. Vaccines for protection against smallpox and swine pox.

When cases of MPOx began to be recorded in the United States and Europe in 2022, health officials quickly distributed millions of doses of existing vaccines. However, during the first two years of the outbreak, no vaccine was available in the DRC.

The Democratic Republic of the Congo, like most African countries, No The country lacks the infrastructure to produce the vaccine, nor can it afford the millions of doses it will produce. (Each dose of the MPox vaccine costs just under $100, according to Cassia; DRC only $649) Therefore, these countries must rely on donations from the United States, Europe and other countries. After the outbreak of the new crown epidemic, the Africa Centers for Disease Control and Prevention began to lead effort to fill this critical gap, but progress has been slow.

During this hiatus, officials in the DRC and other African countries have been operating their outbreak response efforts without a vaccine. It wasn’t until last month that the first Jynneos began arriving in the DRC. But the country has received only 200,000 doses, according to Lewis, forcing staff to piece together a plan outlining how they will use those limited resources. Cascia did not elaborate on how Africa CDC would assist in that process.

Donor governments have been providing technical and financial support for the MPOX outbreak response in Africa. Last week, the United States Agency for International Development (USAID) announced that it would increase its $10 million Funding to support MPOX response efforts in the Democratic Republic of the Congo.

It is unclear whether Africa CDC’s designation of ASF as a continental emergency will have any impact on ASF vaccine supply. However, Africa CDC appears to be taking the lead in directing domestic resources to respond to ASF. Earlier this month, the African Union issued a $10.4 million Funding for mpox response.

“This is the struggle of all Africans and we will fight this together,” Casillas said.