On 13 August 2024, we at the Africa Centres for Disease Control and Prevention (Africa CDC) declared the ongoing mpox outbreaks a Public Health Emergency of Continental Security (PHECS). This declaration marks an important moment in Africa's public health history and shows the gravity of the situation and the need for a unified, continent-wide response to this rapidly spreading disease.

The mpox outbreak in Africa has so far infected over 17,500 people in 2024 alone, a 160% increase in cases compared with the same period in 2023, with children (especially those under 15 years of age) disproportionately affected. The outbreak's rapid spread was coupled with humanitarian crises in regions such as South Kivu in the Democratic Republic of Congo, which have complicated efforts to track and treat infections effectively and were considerations for the declaration of emergency.

There is now an urgent need for coordinated national, regional and international actions to stop the spread of the mpox virus. The decision to declare a PHECS was guided by criteria covering nine areas, developed by the Africa CDC Emergency Consultative Group. These criteria aim to enhance surveillance, improve testing and diagnostics, expand contact tracing, and ensure equitable vaccine access, especially for vulnerable populations. Steps now need to be taken by Africa CDC to implement these recommendations.

Preparations have already begun. A workshop was held by Africa CDC, in collaboration with the US National Center for Biotechnology Information (part of the US National Institutes of Health), in June 2024, in Addis Ababa, Ethiopia, to train participants in real-time sharing of data on pathogens, which will be crucial for public health threats such as mpox. That event built on the African CDC's support of African Union Member States in developing and establishing high-quality information and technology systems to enhance data collection, reporting and analysis.

Healthcare systems must be bolstered to handle the increased disease-management burden of mpox. This includes ensuring the availability of necessary medical supplies, expanding hospital capacities, providing adequate training for healthcare workers, and strengthening community health systems to manage mild cases at home and reduce pressure on hospitals. More investment is needed for these Africa CDC-led community health workforce programs.

Africa CDC is collaborating with global partners, including the European Commission's Health Emergency Preparedness and Response Authority and Bavarian Nordic, to secure over 215,000 doses of the MVA-BN vaccine, which has been approved for mpox by the US Food and Drug Administration and the European Medicines Agency. Africa CDC will ensure these vaccines are distributed equitably, prioritizing local needs in the affected Member States, including vulnerable populations, immunocompromised people and healthcare workers.

Communication about mpox must be tailored to Africa's diverse communities. Early community engagement is needed to prevent misinformation, disinformation, stigma and discrimination. Africa CDC will expedite actions from its recent Kampala workshop for Risk Communication and Community Engagement.

Africa CDC is enhancing cross-border surveillance across African Union Member States by strengthening surveillance at points of entry, training staff and improving coordination with national disease surveillance systems, as well as supporting operational research, knowledge sharing and regional collaboration. Collaboration, cooperation, coordination and data sharing between neighboring countries are essential to ensure that mpox outbreak control measures are consistent and effective.

Mpox was declared a PHECS in part to unlock access to emergency resources, including funding, personnel and technical support, but the mpox outbreaks in Africa are a global concern, with the potential for international spread. Africa CDC is working with African country leaderships to mobilize domestic resources, deploy rapid response teams, set up emergency operations centers and establish contingency plans for potential outbreak scenarios.

Mpox outbreaks can have far-reaching economic and social consequences, including for trade and travel and through disruptions to essential services. According to standing recommendations for mpox by the director general of the World Health Organization, in accordance with the International Health Regulations, there will be no travel restrictions. This will promote essential health service continuity and ensure social stability.

Success hinges on collaboration between African Union Member States, efficient allocation of resources and consistent community engagement. Only a unified effort will lead to long-term containment of the mpox virus and protect lives and livelihoods. Africa CDC asks its global partners to stand with Africa in this critical hour — more resources are needed to curb this outbreak.

Acknowledgments

The author thanks M.O. Folayan, N. Ngongo and J. Kaseya for assistance in writing this piece.

Competing interests

N.N. is coordinating the mpox response for the African Union and Africa CDC but declares no competing interests.