Mpox Challenges: Are We Prepared to Address the Threat?

Current Status of Mpox

Mpox, previously known as monkeypox, is back in the news. As of early September, the World Health Organization has reported more than 5,000 laboratory-confirmed cases this year. Given the well-documented shortcomings of mpox surveillance, these numbers underestimate the true magnitude of the disease burden. The highest number of cases are in the Democratic Republic of Congo.

Urgent Need for Action

The current outbreak has expanded to several other countries in Africa. The first case outside that continent appeared in Sweden, in a patient who returned from Africa; it’s only a matter of time before a case shows up in the United States, although the extent of a potential U.S. outbreak is uncertain. To combat the spread of mpox, the Africa Centers for Disease Control and Prevention and the World Health Organization have declared a public health emergency.

Lessons from Past Outbreaks

How the world, and the U.S., responds to this latest flare-up will test whether we are at all better prepared to confront global health emergencies since the COVID-19 pandemic. The current uptick, primarily driven by a new virus strain, clade I, is different from the 2022 mpox surge, which was successfully controlled by the U.S. and other countries.

Vaccine Preparedness

• Ensuring adequate vaccine supplies should be the highest priority.
• Danish vaccine manufacturer Bavarian Nordic is one of a few companies in the world with an approved mpox vaccine.
• More than 250,000 doses have been sent to the DRC, with the potential for an additional 2 million doses by year-end.

Evaluating Vaccine Efficacy

Another urgent need is to evaluate the efficacy of the mpox vaccine against the new strain. Previous evaluations have primarily focused on effectiveness against clade II.

Investment in Prevention

Modest investments in the early stages of outbreaks can prevent much larger financial costs associated with widespread epidemics. Failure by high-income countries to ensure that the World Health Organization and Africa CDC have the financial resources to fight this now may result in a much more expensive outbreak in a few months.

Combatting Misinformation

Fast-moving outbreaks also have the tendency to increase the spread of misinformation. Evidence from behavioral science supports preemptively “inoculating” the public against misinformation.

The Time to Act is Now

If we don’t respond within that window, we may face déjà vu from our imperfect COVID response, when delays in getting ahead of outbreaks caused unnecessary suffering.