The Current International Mpox Emergency and the U.S. Role: An Explainer
October 2, 2024
In 2024, major mpox outbreaks, particularly in the Democratic Republic of Congo (DRC), prompted the WHO and Africa CDC to declare a public health emergency. This outbreak, driven by the clade I strain, affects both children and adults. The U.S. has increased support, donating vaccines and funds. Global efforts face challenges including vaccine distribution, poor health infrastructure, and misinformation. While the U.S. hasn't reported clade I cases, clade II infections continue among gay and bisexual men. The CDC estimates the risk to the U.S. general public from the African outbreak is very low. This marks the second global mpox emergency, following the 2022-2023 outbreak.
In mid-August 2024, the World Health Organization (WHO) and Africa Centres for Disease Control and Prevention (Africa CDC) declared mpox a public health emergency requiring global coordination. This decision followed major outbreaks in African countries, particularly the Democratic Republic of Congo (DRC), with cases linked to the DRC outbreak identified in countries like Sweden and Thailand.
This marks the second global mpox emergency, differing from the 2022-2023 outbreak. The current situation involves two strains: clade I, prevalent in Africa, and clade II, affecting mostly gay and bisexual men globally. Clade I includes variant Ia, primarily affecting children, and Ib, spreading among adults through sexual contact.
The U.S. government has intensified its support, providing 60,000 vaccine doses to African countries and $10 million in specific funding. President Biden pledged an additional 1 million doses and $500 million to support African mpox response efforts.
Global response efforts have accelerated, with the Africa CDC, WHO, and affected governments developing updated plans, mobilizing funds, and working to secure more vaccines. However, significant challenges persist, including:
1. Difficulties in large-scale vaccine distribution
2. Limited access to prevention tools
3. Poor health infrastructure in affected areas
4. Ongoing conflicts and instability
5. High levels of distrust and misinformation in communities
As of September 26, 2024, no clade I mpox cases have been identified in the U.S., with the CDC estimating a very low risk to the general public from the African outbreak. However, clade II infections continue to occur in the U.S., primarily among adult gay and bisexual men, though at lower rates than during the previous emergency.
The situation underscores the need for continued global vigilance, improved healthcare infrastructure, and targeted public health interventions to control the spread of mpox and protect vulnerable populations.