MPOXED

The continued lack of an effective antiviral treatment for mpox, especially the severe Clade 1a and 1b strains, highlights a critical unmet medical need in global public health. With case fatality rates as high as 3–4%—and children disproportionately affected—current responses rely solely on vaccines and supportive care. NanoViricides' Phase II trial of NV-387 in the Democratic Republic of Congo marks a significant step forward. If successful, NV-387 could become the first targeted oral antiviral for mpox, fulfilling a long-standing treatment gap and reinforcing global health security amid a persistent public health emergency.

The alarming rise of mpox cases in Sierra Leone—611 last week alone—demands urgent international attention. Representing over half of all cases in Africa, the outbreak’s rapid spread, particularly in Freetown and its surrounding districts, signals a critical risk of cross-border transmission. While testing coverage remains robust, weak contact tracing hampers containment. Africa CDC’s vaccination campaign has already reached over 30,000 people in two weeks, but with 6.4 million doses needed continent-wide, urgent global support is essential. Mpox remains a public health emergency, and sustained investment in vaccines, contact tracing, and community education will be key to halting its escalation.

Sierra Leone now accounts for over half of Africa’s confirmed mpox cases this week, with 384 new infections—marking a 63% surge and underscoring the country’s central role in driving the continent’s outbreak, according to the Africa CDC. Limited funding, insufficient contact tracing, and inadequate treatment capacity—only 60 beds for 800 active cases—are compounding the crisis. Although cases are declining in Uganda and Burundi and stabilizing in the DRC, Sierra Leone's escalation highlights the urgent need for strengthened surveillance and resources. With WHO maintaining mpox’s classification as a public health emergency, the international community must prioritize response funding.

Mpox cases in Sierra Leone are surging dramatically, with the country now averaging 100 new infections daily and accounting for half of Africa’s confirmed cases last week. The outbreak, driven by clade 2b, predominantly affects males aged 30 to 35 and includes a significant number of patients with HIV. While nearly 24,000 people—mainly health workers—have been vaccinated, limited isolation beds and low contact-tracing capacity hinder containment. Despite this, Africa CDC reports promising progress in other high-burden countries like Uganda, Burundi, and the DRC. Continued vigilance, funding, and expanded vaccination remain vital to halt the virus’s spread across the region.

Bavarian Nordic has secured a $143.6 million expansion of its contract with the U.S. government to supply freeze-dried JYNNEOS® smallpox/mpox vaccines, following FDA approval of the formulation in March 2025. The Biomedical Advanced Research and Development Authority (BARDA) exercised options to convert existing vaccine stock and support long-term shelf life, with deliveries expected in 2026. The freeze-dried version offers logistical advantages for national stockpiles. Since 2003, Bavarian Nordic has partnered with the U.S. on vaccine preparedness, and this latest investment underscores continued federal commitment to bolstering biosecurity and ensuring future mpox and smallpox response capacity.

This week, the Democratic Republic of the Congo will receive 200,000 new mpox vaccine doses from Gavi, the Vaccine Alliance, bolstering the country’s response to one of the world’s most severe mpox outbreaks. With over 20,000 cases and 49 deaths reported by mid-April 2025, DRC has now received more than 950,000 doses in total. The new shipment will target high-risk regions, especially areas affected by mass displacement. This delivery, part of Gavi’s broader emergency response effort alongside WHO, Africa CDC, and UNICEF, underscores the critical importance of international solidarity in combatting Clade Ib mpox and preserving global public health.

The U.S. Centers for Disease Control and Prevention (CDC) has committed nearly $1 million to help Tanzania combat the spread of mpox. The funding will enhance infection surveillance, prevention, and control across both mainland Tanzania and Zanzibar. Resources will support health facilities, emergency operations centers, and public awareness campaigns, as well as bolster laboratory capacity and border screening. This collaboration reflects the U.S. government’s strategic investment in global health security, reinforcing Tanzania’s response capacity and safeguarding communities. Such partnerships are critical not only for local disease containment but also for preventing wider international transmission of emerging infectious threats like mpox.

Recent mpox outbreaks have underscored the need for a sustainable global response. Gavi, the Vaccine Alliance, currently supports vaccine deployment in African countries and is planning to establish an emergency mpox vaccine stockpile. This initiative would ensure rapid response to future outbreaks and incentivize manufacturers to maintain production despite unpredictable demand. However, the creation of the stockpile depends on Gavi’s success in raising $9 billion for its 2026–2030 strategic cycle. A stockpile would move global health efforts beyond the current reliance on emergency donations and fragmented supplies, ensuring equitable and timely access to vaccines during future public health emergencies.

In North Kivu, Democratic Republic of the Congo, mpox cases are surging amid mass displacement caused by armed conflict. Over 3,300 suspected cases have been recorded this year. In response, UNICEF and partners have deployed 12 mobile vaccination teams to hard-hit areas like Goma. At Kabingo Primary School, children exposed to a confirmed case are receiving the vaccine to curb the spread. Community engagement is central to the campaign’s success, with students and parents advocating for vaccination after firsthand experiences with the disease. The initiative is supported by Gavi, the Mastercard Foundation, the UK FCDO, and the European Union.