The MPOX epidemic continues to strike several African countries at the start of 2025, with particularly active households in East Africa and West Africa. While Health authorities intensify their efforts, the disease still poses important challenges to several health systems on the continent.
Since January 2025, the African continent has recorded 10,944 confirmed cases of MPOX and 63 deaths, according to the latest report by the world Health Organization (WHO). These figures are added to the 20,009 cases reported during the year 2024, confirming the persistence of the epidemic despite the efforts made.
The last six weeks have been particularly worrying with 2,896 new infections. Three countries concentrate the majority of cases: Uganda (1,343), the Democratic Republic of Congo (807) and Burundi (198).
Sierra Leone and Uganda: new epicenters
Sierra Leone has become the new West African epidery of the epidemic, with 384 confirmed cases in a single week, representing more than 50% of infections on the whole continent. Even more worrying, these figures mark an increase of 63% compared to the previous week confirming the explosion of the epidemic in the country.
Uganda, on the other hand, has established itself as the main world center of MPOX with 200 to 300 new weekly cases. This worrying situation makes this country in East Africa the biggest contributor to global statistics reports WHO.
The DRC still hardly affected
In the Democratic Republic of the Congo, the situation remains critical despite a slight decline in the epidemic curve. The country has already recorded 5,197 cases since the beginning of 2025, after having counted 15,067 infections in 2024. The Congolese health authorities feared, however, a sub-depisting linked to the difficulties of access to the laboratories in certain regions.
Meanwhile, Burundi is experiencing a gradual decline in cases, while Malawi has just notified its first cases of Clade IB, signaling the emergence of community transmission in this country hitherto spared.
-A continental health response to persistent challenges
Faced with this situation, the Africa CDC (African Center for Disease Control and Prevention) has extended the status of “emergency of continental health” (Phecs). Currently, 15 African countries remain in the active response phase, the most worrying outbreaks affecting Sierra Leone, Uganda and conflict zones in the DRC.
The joint OMS – Africa CDC 2.0 response plan, covering the period from March to August 2025, emphasizes two main axes:
- Vaccination, with 662,000 MVA-BN doses already administered, 88% in the DRC
- Strengthening epidemiological surveillance
Despite these coordinated efforts, several obstacles hamper the effectiveness of the response:
- Insufficient funding
- Difficulties in the search for contacts
- A limited hospitalization capacity. The case of Sierra Leone is particularly illustrated this last point, with only 60 beds available for more than 800 active patients.
Understand Mpox: a disease with multiple faces
- MPOX is a zoonosis caused by an orthopoxvirus close to smallpox. The disease manifests itself in different forms according to the clades (genetic variants) of the virus:
CLADE I (IA and IB subtypes): predominant in Central and Eastern Africa, it has a historical lethality of up to 10%. The IB subtype is responsible for the current African resurgence. - Clade II (Subtypes IIA and IIB): Traditionally present in West Africa, this clade has spread worldwide in 2022. Its lethality is generally less than 1%.
Typical symptoms first include pseudo-grippal syndrome, followed by a vesiculo-pustular eruption that can leave scars. The transmission is mainly by narrow skin-to-skin contact, by respiratory droplets or through contaminated objects. The exact animal reservoir of the virus remains unidentified with certainty to date.
An epidemic story of more than 50 years
The history of mpox is dotted with several key stages:
- 1958: initial discovery of the virus in laboratory macaques in Denmark
- 1970: First human case documented in a 9 -month -old infant in the DRC, coinciding with the gradual stop of antivariolic vaccination
- 1996-1997 and 2017-2018: Important regional outbreaks in the DRC then in Nigeria
- 2003: First spread outside Africa, in the United States, via imported rodents
- 2022-2023: global epidemic of the IIB clade affecting more than 100 countries, leading the WHO to declare and then lift an emergency of public health of international scope (USPPI)
- August 2024: second USPPI declared in the face of African resurgence, particularly in the DRC
- 2024-2025: Installation of the IB clade in several African countries and resurgence in Sierra Leone, Uganda, Burundi and DRC
Public health experts believe that with adequate funding to improve the diagnosis, deploy targeted vaccination and strengthen community communication, the continent could reach an epidemic platform by early 2026.
This article is based on data report n ° 51 of the WHO, with figures arrested on April 20, 2025.
