Africa | Mpox Epidemic – Emergency Appeal Strategy (MDRS1003) – Democratic Republic of Congo

attachment

• April 2022: MPOX cases are reported in several African countries, including the Democratic Republic of the Congo and Nigeria. The DRC sees infections rising again.

• June 2022: First cases of mpox detected in neighboring countries of the Democratic Republic of the Congo, including Uganda and Cameroon, raising concerns about cross-border transmission.

• November 2023: The African Centers for Disease Control and Prevention (AfCDC) releases a report highlighting ongoing challenges and advances in mpox control.

• March 2024: MPOX outbreaks in Equateur Region (DRC) and Central African Republic raise concerns. At this stage, several African countries continue to report cases, including the Democratic Republic of Congo, Ivory Coast, South Africa, Nigeria, Republic of Congo, and Cameroon.

• April 2024: DRC Red Cross expands response in Equator province with support from IFRC

• July 2024: The number of infected people increases rapidly in eastern DRC (mpox-free area). This new clade is responsible for this epidemic. Cross-border transmission to Uganda, Kenya, and Rwanda has been confirmed.

• August 2024: AfCDC declares the mpox outbreak a public health emergency of continental concern. A few days later, the WHO declared the outbreak a global threat. The IFRC issues an emergency appeal of CHF 40 million to support the 30 million people affected and at risk.

Event description

The number of mpox cases and deaths is rapidly increasing in Africa, with more than 25,000 suspected and confirmed cases and 32 confirmed deaths in 15 countries in 2024. In comparison, the number of cases and deaths have increased by 180% and 25%, respectively. The Democratic Republic of the Congo (DRC) is the epicenter of this outbreak, with 90% of the total cases in the African region. Cases have occurred in all provinces of the Democratic Republic of the Congo, with multiple clade 2 co-occurring in endemic and non-endemic provinces. Cross-border transmission from the eastern provinces of North and South Kivu to neighboring countries is increasing, particularly in Burundi, where 1,500 cases have now been reported, but also in Kenya as well as Rwanda and Uganda. is expanding.

In endemic countries such as Nigeria, the Central African Republic, Cameroon, and Ivory Coast, outbreaks are slowly expanding or reemerging. The 2022 global pandemic continues and has spread to South Africa. This marks the first time that mpox cases and sustained transmission have been reported simultaneously in endemic and non-endemic countries and in multiple clades (clades 1a, 1b, 2) in different geographic regions.

These developments are associated with an increased risk profile for the population due to poverty, tight access to health services, and near non-existent vaccine supplies (to address M.P.O.X.), and the African Centers for Disease Control and Prevention and the Global He led organizations such as health organizations. Declaring this outbreak a public emergency of continental and international concern. The IFRC joined these organizations in raising alert through a statement and activating internal coordination mechanisms to scale up preparedness and response.

The virus is endemic in West and Central Africa, but outbreaks have also occurred in countries outside the endemic region since 2022. In countries with a long history of mpox, outbreaks are clearly more widespread than in previous years, but the routes are unclear. Two distinct clades exist: clade 1 and clade 2. Clade 1 is endemic to Central Africa and has historically been associated with more severe disease and higher mortality rates, and has higher rates of infection compared to clade 2. Clade 1a is present in western and central Africa. Meanwhile, clade 1b was first identified in September 2023 in eastern Democratic Republic of the Congo, where mpox is not endemic. The new clade 1b has so far led to large numbers of cases among a wide range of populations, including sex workers and children, and is rapidly spreading to East African countries.

Growing concerns about zoonotic diseases (viruses that can be transmitted from animals to humans) have been documented to be linked to climate change and environmental degradation. The main factors contributing to this problem include rising temperatures, deforestation, land clearing, habitat loss, and pollution. The World Health Organization's One Health initiative highlights how environmental changes are impacting wildlife, leading to more frequent contact between animals and humans, which is accelerating the spread of viruses.

Reducing biodiversity due to ecosystem destruction can further exacerbate the spread of disease. Climate change is one of the factors contributing to this worsening, disrupting people's lives, causing deforestation, and impacting the surrounding ecosystem. Encroachments on ecosystem boundaries (e.g. through hunting, mining, logging, agriculture, etc.) increase the risk of zoonotic disease spillover events such as mpox. Supporting healthy ecosystems and community resilience is essential to reducing the risk of spillover events.

Due to the new infection levels of 1a and the evolutionary nature of the new clade 1b, many unknowns and uncertainties exist for communities affected by the mpox outbreak. High levels of uncertainty regarding emerging infectious diseases can manifest as social anxiety and panic, especially in areas where prejudice against certain groups already exists. As evidence mounts about the current mpox outbreak, a focus on recognizing the unknowns and addressing issues of trust and concerns expressed by people will co-design comprehensive and adaptable responses and actions. will be essential.