Mpox Still a Continental Emergency, Africa CDC Advisory Group Recommends
September 4, 2025
The Africa CDC’s Emergency Consultative Group has recommended that the Public Health Emergency of Continental Security (PHECS) for mpox remain in place, despite recent declines in cases. While weekly confirmed infections fell by 52 percent between May and August 2025, new surges in Ghana, Liberia, Kenya, and Zambia highlight the fragility of progress. Infant deaths, case fatality rates above one percent in several countries, and gaps in testing and vaccine access underscore persistent risks. The Group warned that lifting the PHECS prematurely could weaken political will and resources. Sustained vigilance, expanded vaccination, and stronger surveillance remain essential to prevent resurgence.
The decision by Africa CDC’s Emergency Consultative Group (ECG) to maintain the Public Health Emergency of Continental Security (PHECS) for mpox reflects a sober assessment of progress and risk. While there has been a 52 percent decline in weekly confirmed cases between epidemiological weeks 17–22 and 27–32 of 2025, the Group cautioned against complacency. Surges in Ghana, Liberia, Kenya, Zambia, and Tanzania, combined with new introductions in Malawi, Ethiopia, Senegal, Togo, The Gambia, and Mozambique, demonstrate how fragile the current gains remain.
The outbreak continues to exact a heavy toll. Infant deaths were reported in Ethiopia and the Central African Republic, and case fatality rates above one percent persist in Sierra Leone, Congo, Malawi, Kenya, Zambia, Ethiopia, South Africa, and Cameroon. The overall continental fatality rate stands at 0.5 percent. Progress in testing coverage, rising from 30 percent in late 2024 to 59 percent by mid-2025, is encouraging, and Burundi has been recognized for decentralizing diagnostics. Yet transport and sample management failures, particularly in the Democratic Republic of the Congo, undermine timely detection and response.
Vaccination remains limited. Over 1.01 million doses have been distributed to 921,000 people across 12 countries, but children under 12—who represent a growing share of cases—remain largely unprotected due to regulatory barriers. The ECG urged expanded access, particularly in high-burden countries.
The Group also warned of reduced international support, including the withdrawal of programmes such as PEPFAR, which places people living with HIV at greater risk. To address these vulnerabilities, the ECG called for expanded community-based surveillance, wastewater monitoring, and rigorous investigation of mpox-related deaths.
The unanimous decision to sustain the PHECS acknowledges progress but emphasizes that recent declines are not yet stable. Africa must sustain continental coordination and integrate mpox efforts with responses to cholera and poliovirus to protect its fragile gains.