Dar Es Salaam – Reductions in foreign aid could result in a significant outbreak of MPOX on the African continent and beyond, and public health experts warn that virus control measures are already in disarray.
MPOX testing and surveillance efforts in hotspot regions like the Democratic Republic of the Congo (DRC) have relied heavily on foreign aid cut under US President Donald Trump.
Health experts say a strong national testing policy focusing on high-risk populations is urgently needed to prevent new MPOX cases from being detected quickly and spread across the border.
“This is a great warning… we are exposed to a major outbreak across continents.”
MPOX testing at DRC is shaking despite thousands of suspected cases across the country, according to the African Centre for Disease Control and Prevention (Africa CDC). Less than a quarter of suspected cases say they are being tested for the disease.
In many cases, samples take more than two days to reach the laboratory, so few patients receive results at a good time to respond effectively.
Since its inception in 2024, the African CDC has seen 114,156 MPOX cases, 26,409 confirmed cases, and 1,696 deaths, reflecting a significant gap between suspected and confirmed cases.
DRC, Burundi and Uganda account for 95% of confirmed cases.
Africa’s CDC Director Jean Kaseya said the growing gap was a result of a low test rate and directly linked to the loss of foreign support.
Speaking at the virtual press briefing (March 27), he points to 2025 data from UN trade development, showing a 70% decline in official African development aid.
‘Major Outbreak’
“Due to the reduction in aid and anxiety, we’re not doing well when it comes to sample collection and transport,” said Kaseya, who mentions the situation at the war-torn DRC.
“This is a big warning…we are exposed to a major outbreak across continents.”
Public health experts say the current outbreak is still on an upward trajectory.
Dismasdamien, a global health consultant for the Tanzania-based International Health Association, told Scidev.net:
“Epidemiological surveillance of outbreaks in these areas (such as the DRC) was heavily dependent on foreign aid. Low testing and surveillance means that in many cases it is undetected.”
Damian highlighted the need for an increase in domestic resource mobilization and argued that reliable funding is essential for epidemiological surveillance to prevent cross-border transmission.
Already this year, France and the United Arab Emirates have reported confirmed incidents related to travel from East Africa, Central Africa and the UAE.
In March, Tanzania reported the first two cases of MPOX.
Nyambura Moremi, director of the National Institute of Public Health in Tanzania, said the genome sequencing is underway and he is trying to see which variants are circulating.
George Mkoma, a Tanzanian epidemiologist, researcher at the Statens Serum Institut and researcher at the University of Copenhagen in Denmark, believes that Africa must move away from dependence on foreign aid and adopt a stronger, nationally-led strategy.
“A strong testing strategy focusing on high-risk populations such as long-distance truck drivers will help with rapid case identification and even contact tracing,” he told Scidev.net.
“Each government must strengthen its efforts to protect its people, rather than relying solely on external aid.”
Human communication
In a letter published last week (April 1) in the Nature Journal, scientists from the University of Surrey in the UK warn that MPOX is evolving from animal transmission to a sustained human-to-human spread.
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They say viruses that cause painful rashes and fever, and are now being transmitted primarily through intimate contact, with more aggressive clade I variants appearing.
Researchers say this is worried because variants appear to accumulate certain genetic mutations driven by enzymes in the human body.
They believe that these mutations may alter the properties of the virus, and that MPOX may better adapt to human hosts and improve their infection efficiency.
Researchers say there is an urgent need for better diagnosis, treatment and surveillance systems as viruses spread across Central Africa that cannot be completely eradicated by animal reservoirs and disease sources.
This work was produced by the Sub-Saharan African English Desk at Scidev.net.
