A pox on all our houses: a missing component in the global mpox response is equity

The global health community has had more than a decade to develop pandemic preparedness programmes and apply lessons learnt to new disease outbreaks. Mpox has now been declared a global public health emergency, but the response appears to be missing important elements of equity, focusing instead on diagnosis and surveillance. This approach leaves vulnerable populations in countries grappling with the outbreak without the preventive and treatment services they need. Based on our experiences managing the current mpox outbreak in Burundi, we outline some limitations of ongoing response strategies and advocate for the adoption of core principles that emphasise an equitable approach. These strategies include: community partnerships; care provided across the spectrum of disease; gender-informed services; sensitive community education; and promotion of community cohesion. Although funding and implementing these activities is ultimately the responsibility of governments, additional support might be needed also from non-governmental organisations, especially in settings characterised by conflict and fledgling health systems where the current mpox outbreak is centred.