Goats and soda: NPR

MPOX made the headlines scary in 2022 and 2023: tens of thousands of cases worldwide, with 30,000 in the United States in just one year. There were reports of painful lesions and gigantic efforts to mobilize vaccines.

In 2025, it seems to be just a memory. Only this is not the case.

“You see the agony that the patient is going through. It is on another level,” explains Caroline Mugun, nurse in an MPOX isolation room in Mombasa, Kenya.

In the past year, the virus has quickly spread through borders in Africa. Twenty -four African countries are in the midst of MPOX epidemics – against 13 a year ago, according to Africa Centers for Disease Control and Prevention (CDC). For many of these countries – from Gambia to Kenya, from Uganda to South Sudan – this is the first time that they have seen cases of MPOX.

Today – August 14 – Makes the first anniversary of the World Health Organization declaring MPOX a public health emergency of international concern. This rare distinction indicates the highest level of alert. But criticisms say that the global response has dropped dangerously, despite the fact that $ 1.1 billion was promised by countries, foundations and international organizations to support MPOX control.

Here is an overview of the location of the MPOX crisis and what it means for future epidemics other serious diseases.

“Walking Alite”

Historically, MPOX was associated with distant wooded areas in West and Central Africa. The virus was known to occasionally jump small wild animals to people, often children who chased them away. Although it was initially called Monkeypox due to laboratory cases in primates, the main carrier is considered to be other infected animals, such as rodents. The name was modified in 2022.

When the WHO rang the alarm a year ago, Mpox had a very different profile from that in its early days.

A new strain of the virus – officially called Clade 1B – had just emerged and spread quickly, especially among sex workers and their customers. The epicenter of this epidemic was the eastern part torn apart by the war of the Democratic Republic of Congo. Far from the forest, this area is known for its immense mineral riches and attract workers from many neighboring countries. Soon, the new tension appeared in neighboring nations: Burundi, Kenya, Rwanda and Uganda.

Quick advance from one year until now, and the new strain has taken off. There have also been great epidemics in Africa in the other MPOX strain. According to the number of CDC Africa, there have been around 97,000 suspect cases of MPOX on the continent and nearly 600 deaths so far this year. However, according to MPOX experts, figures are probably a serious sub-account.

“Your case counts is a bit like shadows on a wall – they do not tell you this very precise image,” explains Anne Rimoin, professor of epidemiology at the UCLA Fielding School of Public Health and MPOX researcher. She says that there are many reasons for this, in particular the stigma associated with a sexually transmitted disease and a large part of the affected people living in remote areas where there is limited monitoring and ability to diagnose. The result is that many MPOX patients probably do not receive medical care and are not recorded in the data.

Another reason for the imprecise figures is President Trump’s cuts with foreign help. The Democratic Republic of the Congo was among the main recipients of American foreign aid, and part of this money was gone to the MPOX response, including the transport of samples from clinics to laboratories for tests.

“We have really removed a kind of data cliff,” said Dr. Chris Beyrer, epidemiologist and director of the Duke Global Health Institute at Duke University. “We fly blind. But as the answer is so blocked, I’m not sure it really flies. I think we are probably more like blind.”

What data is suggested that the geographic scope of the virus has developed considerably, but in recent months and weeks, the number of cases on the continent seems to be lower. This makes Dr. Olivier Le Polain, the head of the epidemiology unit and the analysis of the response to the optimistic WHO health emergency program. “When all the information point to the same types of trends, it gives us some confidence that the trend is authentic,” he says.

“Three steps back”

Even with cases of fall, many MPOX specialists raise serious concerns concerning the world response.

“It was essentially a very frustrating year,” said Dr. Boghuma Titanji, assistant professor of infectious diseases at Emory University. “I have the impression that for the two steps of progress that has been made, there were three steps back.”

Titanji and others can check a whole range of reasons why the virus remains uncontrolled. To begin with, the epicenter of the epidemic – in the eastern Democratic Republic of the Congo – is in the middle of a brutal conflict, the rebels control the key cities and the available medical care. Another big problem: this epidemic rose up with a spectacular decrease in the world’s health aid in the United States and a number of European countries, such as France.

“MPOX can certainly serve as a manual case study on how a global health crisis takes place and evolves when you have a biological risk colliding with political and economic forces,” said Rimoin.

Vaccines

Many indicate vaccines as the quintessence of how the answer has gone wrong.

MPOX is a vaccine preventible disease, and yet, to date, only 886,000 people have been vaccinated in a dozen African countries. Just over 3 million doses were delivered to the continent. It is according to Africa CDC, which had previously put the target at 10 million doses available by the end of 2025.

The challenges started early: when the WHO declared the urgency of public health, it still did not have the mpox vaccine.

“It’s like:” Well, you have an emergency or you don’t do it “”, explains Beyrer. At the time, Tedros Adhanom Ghebreyesus, the director general of WHO, pushed the idea that anyone who was slowly moving, saying who experts had no complete information to assess the efficiency and safety of vaccines. “We will not take shortened,” he said.

The donation of American vaccine is an example of a pledge which has failed to materialize fully. The president of the time, Joe Biden, promised to send 1 million doses to Africa in September 2024. However, in July 2025, only about 90,000 had reached the continent. Among the remaining doses, about half are now too close to their expiration date to send, according to Yap Boum, the MPOX response of the deputy chief of the CDC Africa.

“They can no longer be sent to the continent, which is a huge loss, because this dose of vaccine is $ 100,” said Boum.

In Kenya, nurse Mugun – who works for doctors without borders – says that people want the MPOX vaccine, but the country has not yet launched an immunization program.

The American centers for the control and prevention of diseases, as well as the United States Ministry of Health and Social Services, did not respond to the request for NPR comments on the commitment of the American vaccine.

What about the future?

MPOX researchers and doctors say that the global dull response is poorly pressed for the future potential of MPOX as well as for other threats to illness.

Titanji of Emory University fears that the lack of response can reduce the value of the WHO alert system. Ditto with the CDC African Emergency Declaration, which marked the first time that the organization has published a public health emergency for continental security. “If we had the highest level of alert for 12 months for a particular emergency and it did not really put a breach in containment, how much does this lever have an impact?” she asked.

Dr. Jean Kaseya, CEO of Africa CDC, does not agree with the suggestion that few things happened to MPOX. “Africa did not have this capacity. It is now that we are strengthening capacity,” he said.

He stressed that a year ago, no African country had granted regulatory approval for the MPOX vaccine that the United States hoped to send. Now, 17 countries have approved it. Likewise, he says, the laboratory network used to test suspicious cases of MPOX has increased significantly in hot spots. For example, Burundi had two laboratories capable of testing MPOX a year ago and now 56.

In addition, he adds, it is the first time that there is coordination and collaboration through the continent with an African organization helping to carry out the charge and to allocate the resources enough. Kaseya argues that without the emergency declaration, the resources that have been pledge would not have been materialized. However, he recognizes that there is much more work to do.

Titanji agrees that there is more work to do. She warns that the world is looking in real time while the virus found itself in the human population. “The virus will evolve more the opportunities that have offered it,” she said.

Rimoin says that so far, in this MPOX emergency, the United States has been largely spared – but it may not last. “The diseases that we ignore abroad can quickly land at our door,” she said. “We have been lucky so far. I don’t know how long our luck will take it.”