[DAR ES SALAAM] 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.
“This is a major alert … We are exposing the continent and even beyond the continent to a major outbreak.”
Jean Kaseya, director general, Africa CDC
According to the Africa Centres for Disease Control and Prevention (Africa CDC), mpox testing in the DRC has faltered, despite the thousands of suspected cases in the country. It says less than a quarter of suspected cases are being tested for the disease.
In many cases, samples are taking more than two days to reach laboratories, so few patients receive their results in good time for an effective response.
Since the start of 2024, there have been 114,156 suspected mpox cases, 26,409 confirmed cases, and 1,696 deaths, according to Africa CDC, reflecting a significant gap between suspected and confirmed cases.
DRC, Burundi, and Uganda account for 95 per cent of the confirmed cases.
Jean Kaseya, director general of Africa CDC, says this widening gap is a result of the low testing rate, which he links directly to the loss of foreign assistance.
Speaking at a virtual press briefing (27 March), he pointed to 2025 data from UN Trade and Development indicating a 70 per cent drop in Official Development Assistance for Africa—from US$81 billion to US$25 billion.
‘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.
This piece was produced by SciDev.Net’s Sub-Saharan Africa English desk.