Mpox is spreading. A new strain of this viral disease — which is easier to transmit than older ones and appears to be more deadly — has gripped the Democratic Republic of Congo throughout the year. Now it has reached other parts of central and eastern Africa, and is starting to appear elsewhere, including the United States.
It is likely to go far, carried by international travelers. According to Airfinity, a health-data firm, Dubai and London are at greatest risk of importing the new strain, known as clade 1b.
Last week the World Health Organization declared mpox a “public-health emergency of international concern.” This designation speeds up the release of funds and helps make more vaccines available. However, more resources and effort will be needed. More than 17,000 people, mostly in Congo, are thought to have had mpox since January. At least 500 have died.
Estimating the lethality of the new strain is hard, because many cases go unnoticed or unreported. Experts believe that between 1.4% and 10% of those infected have died of it, with children likeliest to succumb. However, survival rates may prove higher outside Congo, an exceptionally poor and violent country where many children have immune systems weakened by deprivation.
Mpox causes a fever and a painful, visible rash. It is spread by close contact, for example within households. Congo, where it is concentrated, is an especially difficult place to monitor and curb infections. Much of the east of the country is fought over by rebels.
The government has little access to some areas. Camps for displaced people are crowded, fostering the spread of disease.
Nonetheless, health workers and aid agencies have in the past been able to overcome some of these obstacles. In recent years, outbreaks of Ebola in eastern Congo were contained despite gunmen sometimes burning down clinics. Success requires funding and persistence.
In all the countries at risk, people need to be taught about the symptoms and how to avoid the virus. African governments need to enhance surveillance, contact-tracing and diagnosis, and should be offered aid and technical support.
The Africa Centers for Disease Control has pledged to deliver 10 million mpox vaccines by 2025. That is welcome, but in the short term rich countries should release more vaccines from existing stores. Japan has offered 3.5 million doses to Congo — a good start.
The priority in afflicted countries should be to vaccinate medical workers and those at high risk, such as sex workers, to try to curb the outbreak quickly. Trials are also needed to determine the true efficacy of these vaccines. In the longer term, a global stockpile of mpox vaccines is required, which could be deployed at the start of a future outbreak. Dealing with the virus quickly, at source, is much cheaper than acting later. So countermeasures must be planned in advance. The price of preparation is a small fraction of the cost of dealing with a full-blown pandemic.
Rich and poor countries need to work together more closely. Wealthy places have cash and medical muscle; poor ones have local knowledge and data, such as genetic sequences collected from the field, that can be used to track outbreaks, better understand how rare viruses mutate and create new biotech products.
If rich countries want this information, they should offer drugs and vaccines in return. Containing the spread of emerging diseases is a colossal, unambiguous public good. Because all countries stand to benefit, all should contribute what they can to organizing a swifter, more rational response.
