Hoping that viruses will go away is not enough – what is needed is continuous vigilance
June 26, 2025
Sierra Leone’s growing mpox outbreak is a stark reminder that viruses don’t disappear—they adapt, persist, and resurface where surveillance falters. With over 3,000 confirmed cases and 15 deaths, and clade IIb likely the dominant strain, the country faces mounting strain despite strengthened response efforts. Children remain particularly vulnerable. The outbreak’s rapid spread underscores global risks: infectious threats do not respect borders. Investing in sustained surveillance, equitable vaccine access, and robust local health systems isn’t just ethical—it’s strategic. Sierra Leone’s crisis must catalyze global action before mpox’s resurgence becomes the next international failure of foresight.
Sierra Leone’s escalating mpox outbreak is a warning—and a test—for the global health community. Since January 2025, the country has recorded over 3,000 confirmed cases and at least 15 deaths. Infections are spreading rapidly, particularly in Western Area Urban, Western Area Rural, and Bombali. As national authorities coordinate with WHO, UNICEF, Africa CDC, and Gavi, over 61,000 MVA-BN vaccine doses are expected to arrive, and hundreds of health workers are being trained. Yet the strain on infrastructure remains palpable, with patients sharing beds and diagnostic delays persisting.
More concerning is the virus’s shift: clade IIb, associated with faster transmission, appears dominant. Children—especially malnourished—are at significantly higher risk of death, raising alarm about the outbreak’s potential trajectory. This isn’t just Sierra Leone’s problem. As with COVID-19 and Ebola, global neglect of regional epidemics allows pathogens to mutate and travel. We’ve seen this cycle before.
Unlike richer nations that quelled mpox during the 2022–2023 wave, Sierra Leone lacks the luxury of robust diagnostics, vaccines, and sustained surveillance. Its response is commendable—emergency measures, contact tracing, public messaging—but funding and support are critically limited. The world cannot afford to let attention lapse again.
Tanzania and Rwanda have demonstrated that effective outbreak responses are possible in lower-resource settings—through coordination, transparency, and investment in surveillance. Sierra Leone must not be left to stand alone.
The lesson is clear: surveillance isn’t a temporary tool; it must be embedded in global health strategy. Ignoring small outbreaks is costly. Every delayed diagnosis is a missed opportunity to prevent the next pandemic. The mpox resurgence in Sierra Leone is an opportunity to act decisively. We must not let this become another chapter in the story of preventable global failure. The cost of complacency is global. The time to invest—strategically and equitably—is now.