Mpox in Africa: one year continental response outcomes and way forward

Following the declaration of mpox as both a global and continental public health emergency in August 2024, the Joint Incident Management Support Team (IMST), co-led by the Africa Centres for Disease Control and Prevention (Africa CDC) and the WHO, was activated in Kinshasa, DRC to coordinate the continental mpox response. This article highlights the first year's epidemiological and operational findings.

Key performance indicators across eight IMST pillars (coordination, surveillance, laboratory, case management, infection prevention and control, risk communication and community engagement (RCCE), vaccination and research) were descriptively analysed using data from 28 African Union Member States from January 2024 to August 2025.

A total of 49 803 confirmed cases and 240 deaths (CFR 0.5%) were recorded across 28 countries. The response was supported with US$977 million as tracked by the IMST. Operational achievements included 87% surveillance completeness, 72% contact tracing completeness and improved average laboratory turnaround time from >5 days to 2 days. Laboratory testing capacity expanded from 2 to 27 sites in the DRC and from 1 to 56 decentralised sites in Burundi. RCCE activities reached 50 million people in 21 countries, with vaccine acceptance among high-risk groups rising from 44% to 87%. Operational research achievements included a responsive and functional research coordination mechanism, 24 (92%, 24/26) multi-country clinical and operational research studies implemented and 60% completion rate of the research data and material sharing framework for Africa. Only 938 000 doses (32%) of the 3.1 million vaccine doses delivered were administered.

The joint continental IMST is a new benchmark for response governance, successfully mobilising resources and scaling up diagnostics under unified co-leadership. On the other hand, the evaluation revealed persistent structural challenges in last-mile vaccine delivery, contact tracing (due to stigma/funding) and weak regional collaborative research including fragmented regional research priorities. Future focus must shift from emergency action to durable, sustained investment in national and sub-national health security architecture using a multisectoral whole of government approach.