African countries see payoff from ramped-up mpox strategies
April 25, 2025
Mpox cases in Africa have declined over the past six weeks, driven by intensified public health efforts like expanded community health worker contact tracing, according to Africa CDC officials. While Burundi and the DRC are showing promising declines, 17 of 24 affected countries still report active transmission. Malawi has newly confirmed community transmission of clade 1b mpox. Vaccination campaigns are scaling up, and rapid diagnostic tests are under evaluation to improve early case detection. Despite positive trends, officials remain cautious, citing conflicts, low testing rates, and concurrent outbreaks like measles as ongoing challenges to fully containing the virus.
After six weeks of intensified public health measures, including decentralized testing and expanded contact tracing, Africa is seeing a promising decline in mpox cases, according to Africa CDC's latest briefing. Burundi, once averaging 200 weekly cases, now reports about 30 per week, and officials say sustained outbreak response improvements are strengthening the country’s overall health system. Encouraging trends are also emerging in the Democratic Republic of the Congo (DRC), despite major challenges such as armed conflict in North and South Kivu and foreign aid cuts that have hampered outbreak management.
In the DRC’s capital Kinshasa, community health workers are conducting door-to-door case finding, linked to a targeted vaccination strategy supported by over 750,000 doses already received and more on the way. However, the outbreak’s complexity persists. Conflict-ravaged areas face overlapping measles outbreaks that complicate mpox diagnosis, underscoring the urgent need for multiplex testing tools.
Meanwhile, Malawi has declared a new mpox outbreak, with four confirmed clade 1b cases across two districts. None of the infected individuals have travel histories to outbreak areas, indicating local transmission. Africa CDC stresses that early community transmission detection highlights the need for strengthened surveillance and swift response.
Efforts to introduce rapid mpox tests, evaluated at the DRC’s National Institute for Biomedical Research, could be a game-changer for outbreak control, enabling faster case identification even in the most resource-limited settings.
Despite the declining case numbers, Africa CDC officials urge caution. Testing rates remain low in many areas, and cross-border transmission risks persist. As vaccination campaigns expand and diagnostic capacities improve, the next phase of the mpox response will hinge on sustaining vigilance, securing additional resources, and addressing the structural vulnerabilities that allowed the outbreak to spread.