A deadly new outbreak is testing Africa’s ambitious public health efforts

In the summer of 2022, following two years of the Covid-19 pandemic, the US was faced with another public health crisis. A virus called mpox, widely known as monkeypox, began spreading in developed countries. The virus can cause severe rashes and, in a small percentage of cases, death. At its peak, the US reported nearly 500 new daily cases. However, developed nations managed to contain the outbreak with effective testing and vaccines. The World Health Organization declared the global mpox emergency over in May 2023. Meanwhile, in the Democratic Republic of Congo (DRC), a deadlier version of mpox was spreading due to sexual transmission, marking a first in the virus’s history. The country reported over 12,500 suspected cases and 581 deaths, both all-time highs. The World Health Organization has warned about the potential worldwide spread of the virus.

The existing mpox vaccine, widely available in the US, could stop transmission of this deadlier strain, but is not available in the DRC. The manufacturer, Bavarian Nordic, has cited bureaucratic hurdles and the lack of local regulatory approval as reasons for not providing doses to the DRC and other African nations.

This situation reflects what African nations experienced during the Covid-19 pandemic. While Covid vaccines were widely distributed in wealthier nations, African countries were left behind. The continent depended on importing vaccines from wealthier nations that were hoarding doses for their own citizens. As a result, the African public health response has been limited by a lack of research and development capacity, as well as challenges in vaccine production. Foreign-backed public health initiatives have historically focused on specific disease outbreaks rather than strengthening local health systems.

As the global health community tries to draw lessons from recent events, a strategy focused on developing in-country institutions to adapt to future health emergencies is recognized as crucial. African leaders, frustrated with the dependency on foreign aid, have called for a new public health order on the continent, prioritizing local health capacity building.

The New Public Health Order for Africa emphasizes the need for a strengthened African CDC, a more robust vaccine manufacturing sector, and increased public health investment. The continent also needs a transnational approach to address public health challenges exacerbated by cross-border travel.

Creating a more robust, self-sufficient public health infrastructure in Africa will be a long-term endeavor. Given Africa’s evolving health challenges and growing population, the focus will be on strengthening primary care, expanding surveillance systems, improving laboratory capabilities, and conducting more local research to inform public health responses.

The African public health order represents a significant shift, aiming to address the weaknesses in the continent’s public health infrastructure. The coming years will determine if Africa can establish a new, self-sustaining path in public health.