Africa's Mpox Emergency Continues

The Emergency Consultative Group (ECG), which advises the Director-General of the Africa Centres for Disease Control and Prevention (Africa CDC) on mpox, has recently urged that the Public Health Emergency of International Concern (PHEIC) remain in place.

Meeting on September 2, 2025, to review the outbreak and assess whether the emergency status should be lifted, the Group concluded that maintaining the declaration is essential to preserve political will, mobilise resources, and keep countries on high alert.

Members warned that lifting the status prematurely could lead to complacency, reduced funding, and an increased risk of resurgence.

The PHECS was first declared on August 13, 2024.

The Group's recommendation announced on September 4, 2025, followed a detailed review of the mpox situation. 

Recent surges have emerged in Ghana, Liberia, Kenya, Zambia, and Tanzania, with fresh introductions of the virus reported in Malawi, Ethiopia, Senegal, Togo, The Gambia, and Mozambique.

At the same time, several countries — including Sierra Leone, Congo, Malawi, Zambia, Kenya, CAR, Ethiopia, South Africa, and Cameroon — continued to register case fatality rates above one per cent.

The overall continental case fatality rate stood at 0.5%

More than 1.01 million vaccine (JYNNEOS®, MVA-BN®, IMVAMUNE®) doses have been administered to 921,000 people across 12 countries. However, regulatory approval for vaccinating children under 12 remains absent in many high-burden settings, despite the presence of pediatric cases.

The Group also called for more rigorous investigation of mpox-related deaths, particularly among children, and for expanding vaccine access to under-12s in high-risk countries.

Ethiopia and the Central African Republic reported infant deaths.

To address these challenges, the ECG recommended strengthening sample collection and referral systems, including the use of community-based surveillance and wastewater monitoring as early warning tools.

The ECG further advised maintaining strong continental coordination, integrating the mpox response with other ongoing health emergencies such as cholera and circulating vaccine-derived polioviruses, and developing a scalable, tiered alert system to sustain vigilance without relying solely on a binary emergency declaration.

To alert international travelers of the mpox risk, the U.S. CDC's Level 2 Travel Health Advisory remains active as of September 2025.

There are outbreaks of clade II mpox in Liberia and Sierra Leone, where mpox is endemic.

Unlike the ongoing global clade II mpox outbreak that began in May 2022, these outbreaks have affected males and females approximately equally. Furthermore, person-to-person transmission has occurred during this outbreak, including through sexual or other intimate contact.

The CDC recommends mpox vaccination for specific travelers to Liberia and Sierra Leone.

Most clinics in the United States offer the U.S. FDA-approved mpox vaccine.