Mpox: The new adversary

The recent announcement by the Nigeria Centre for Disease Control and Prevention (NCDC) of 40 confirmed Mpox cases out of 830 suspected cases highlights the country’s vulnerability to this escalating threat. The virus’s spread across 12 states, particularly in the South-South and South-East regions, signals a growing crisis that demands urgent intervention.

While the Ministry of Health’s requirement for travellers to submit health declarations is a positive step, it is insufficient to combat the spread of Mpox effectively. The declaration of Mpox as a public health emergency by the Africa Centre for Disease Control and Prevention (Africa CDC) underscores the urgency of the situation, and Nigeria must act swiftly.

Dr. Jean Kaseya, Director General of Africa CDC, has emphasised the need for proactive and aggressive measures to contain and eliminate this threat. South Africa has reported at least 24 Mpox cases, and as of August 4th, the CDC notes that since January 2022, Mpox has affected 38,465 people across Africa, resulting in 1,456 deaths. Central and Eastern Africa, particularly the Democratic Republic of Congo, have been the hardest hit, with over 17,000 infections and more than 500 deaths in 2024 alone.

Given Mpox’s spread both within Africa and internationally, the World Health Organization (WHO) declared a global health emergency last week, marking the second such declaration in two years.

Mpox, related to smallpox, was first identified in 1958 in monkeys, although it does not originate from them. The virus can be transmitted from animals to humans and between humans through physical contact. There are two clades: Clade I, endemic to Central Africa, and Clade II, found in West Africa. A new variant of Clade I, known as Ib, appears to have a higher transmission rate. Symptoms include a skin rash or mucosal lesions lasting two to four weeks, along with fever, headache, muscle pain, back pain, fatigue, and swollen lymph nodes.

Efforts to contain Mpox remain challenging. Historical global epidemics show that even well-prepared plans can fail. Treatment involves supportive care, while smallpox vaccines and therapeutics approved in some countries can be used for Mpox in certain cases. Prevention includes avoiding physical contact with infected individuals and vaccination for those at risk.

Given the difficulties in preventing the disease from entering new regions and our recent struggles with cholera—an indicator of deep-seated poverty—there are concerns about the adequacy of our preparation and response protocols for such crises.

Our ongoing battle with cholera highlights persistent systemic issues. However, our experiences with Ebola and COVID-19 should provide valuable insights and strategies for managing rapidly spreading diseases like Mpox.

Yet, the Ministry of Health and NCDC need to significantly enhance their efforts. Public awareness about Mpox remains disappointingly low. While panic is counterproductive, complacency is equally dangerous. Effective public health campaigns, communicated in local languages and tailored to diverse communities, should have been implemented. Unfortunately, the response has been inadequate.

Underfunding and a brain drain of healthcare professionals have left our system ill-equipped to handle outbreaks like Mpox. The Africa CDC’s revelation that the continent needs over 10 million vaccine doses but only has 200,000 available is a stark indictment of the government’s failure to invest in healthcare.

The donation of Mpox vaccines from the United States Government to Nigeria is a welcome development. However, the government’s primary responsibility remains the welfare and security of its citizens. This responsibility is being tested in real-time.

The Mpox outbreak is a call to action for Nigeria’s health sector. We must strengthen surveillance systems, enhance testing capabilities, and improve contact tracing mechanisms. Prioritising vaccination and ensuring that healthcare workers have the necessary resources and training is crucial.

This is not a time for complacency or reactiveness; it is a time for collective action and decisive leadership. Nigeria’s healthcare system is under strain, and we must rise to the challenge. The government must act decisively to contain and eliminate the Mpox threat.

The time for denial is over; the time for action is now. Nigeria must confront this threat head-on and work towards containing and eliminating it. Anything less would be a failure to protect the health and well-being of our citizens. Immediate action is required to prevent further spread of Mpox in Nigeria.

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