Africa faces growing mpox threat amid foreign aid reductions

Foreign aid cuts could result in a major outbreak of mpox across the African continent and beyond, with virus control measures already disrupted, public health experts warn.

Mpox testing and monitoring efforts in hotspot areas like the Democratic Republic of Congo (DRC) were heavily reliant on foreign assistance, which has been slashed under US President Donald Trump.

Health experts say strong national testing policies, focused on high-risk populations, are now urgently needed to ensure new mpox cases are detected quickly and to prevent the disease spreading across borders.

‘Major outbreak’

“With the aid cut and insecurity, we are not doing well in terms of collecting and transporting samples,” said Kaseya, referring to the situation in war-torn DRC.

“This is a major alert … We are exposing the continent and even beyond the continent to a major outbreak.”

Public health experts say the current outbreak is still on an upward trajectory.

Dismas Damian, a Tanzania-based global health consultant with the Canadian Society for International Health, told SciDev.Net: “This is likely to spill over to other countries.

“Epidemiological surveillance of outbreaks in these areas [such as DRC] relied heavily on foreign aid. With low testing and surveillance, it means many cases are going undetected.”

Damian stressed the need for increased domestic resource mobilisation, arguing 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 cases linked to travel from East Africa, Central Africa, and the UAE.

In March, Tanzania reported the country’s first two cases of mpox.

Nyambura Moremi, director of Tanzania’s National Public Health Laboratory, said genome sequencing was underway to try to ascertain which variant was circulating—a crucial detail for understanding the virus’s spread.

George Mkoma, a Tanzanian epidemiologist and researcher with Statens Serum Institut and the University of Copenhagen, Denmark, believes Africa must move away from dependence on foreign aid and adopt stronger, nationally-driven strategies.

“A strong testing strategy, focusing on high-risk populations such as long-distance truck drivers, would help in rapid case identification and even contact tracing,” he told SciDev.Net.

“Each government must step up efforts to protect its own people, rather than relying solely on external aid.”

Human transmission

In a letter published last week (1 April) in the journal Nature, scientists at the University of Surrey, in the UK, warn that mpox is evolving from animal-to-human transmission to sustained human-to-human spread.

They say the virus, causing painful rashes and fever, now transmits primarily through intimate contact and that more aggressive clade I variants are emerging.

The researchers say this is worrying as the variants appear to be accumulating specific genetic mutations driven by enzymes in the human body.

They believe these mutations may be changing the virus’s properties, potentially helping mpox better adapt to human hosts and improve its transmission efficiency.

The researchers say there is urgent need for better diagnostics, treatments, and surveillance systems, as the virus—which cannot be fully eradicated due to animal reservoirs, or sources of the disease—continues spreading beyond Central Africa.