Swift U.S. Response Needed to Contain Mpox Outbreak in Africa

The director general of the World Health Organization (WHO) declared a public health emergency of international concern (PHEIC) on August 14 due to a surge in cases of mpox, formerly known as monkeypox, in the Democratic Republic of the Congo (DRC) and surrounding countries. The United States and its international partners must work together to contain this public health emergency.

The U.S. Centers for Disease Control and Prevention (CDC) notes that since January 2023, the DRC has reported more than 22,000 mpox cases and over 1,200 deaths. The disease is endemic to the DRC, but this outbreak is more widespread than previous ones and has spread to neighboring countries, including Burundi, the Central African Republic, the Republic of the Congo, Rwanda, and Uganda.

The CDC explained that the risk to the American public is currently low due to the lack of direct commercial flights and travelers from the affected countries. The Department of Health and Human Services (HHS) noted that the United States “has a robust surveillance system in place, including through clinical testing and wastewater analysis.”

However, the outbreak involves an mpox subtype that is more transmissible and causes more severe infections. Cases could emerge in the United States with direct ties to the outbreak in Africa. Individuals with the new mpox strain were confirmed in separate incidents in Sweden and Thailand after traveling from Africa.

In July 2022, the WHO declared a PHEIC for a different strain of mpox when cases emerged in non-endemic countries. By the time the emergency was declared over in May 2023, more than 95,000 cases had spread across 115 non-endemic countries. The CDC reported that the United States had over 32,000 cases and 58 deaths.

Unfortunately, the Biden administration did not address the 2022 mpox outbreak effectively. The Washington Post detailed the administration’s failure to order enough vaccines or make enough tests available to curb the disease’s spread. The good news is that once the administration got its act together, the spread within the United States was controlled through a surge of testing and vaccinations.

Addressing mpox outbreaks should not be as challenging as the COVID-19 pandemic that emerged in Wuhan, China. Mpox was discovered in 1958, with the first human case in 1970. The Food and Drug Administration approved the Jynneos vaccine in 2019. And whereas Chinese authorities tried to cover up COVID-19’s emergence and obstructed WHO investigations, today the governments of countries affected by mpox are working directly with the WHO, international partners, and others.

Vaccinations will be an important element of the response and should begin soon. The United States has donated 50,000 doses of the vaccine to the DRC. The European Commission’s Health Emergency Preparedness and Response Authority announced a donation of 175,420 doses to the Africa CDC, with a pharmaceutical company donating another 40,000 doses. DRC officials warned that the country needs at least 3.5 million doses to contain the current outbreak, and the head of the Africa CDC said the continent needs at least 10 million doses.

This outbreak is an important test for the Biden-Harris administration, which denigrated the Trump administration’s approach to disease outbreaks. The administration fumbled the last mpox outbreak. It must do better this time.

Anthony Ruggiero is an adjunct senior fellow at the Foundation for Defense of Democracies (FDD). He previously served in the U.S. government for more than 19 years, including as senior director for counterproliferation and biodefense on the National Security Council (2019-2021). For more analysis from Anthony and FDD, please subscribe HERE. Follow Anthony on X @NatSecAnthony. Follow FDD on X @FDD. FDD is a Washington, DC-based, nonpartisan research institute focusing on national security and foreign policy.