…as the Africa Centre for Disease Control calls for effective mpox messaging

26 August 2024 by Pascalinah Kabi

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Nearly thirteen days after the Africa Centre for Disease Control (CDC) declared the mpox outbreak a Public Health Emergency of Continental Security—the first such declaration by the agency since its establishment in 2017—Lesotho remains among the fortunate countries that have not recorded a single mpox case.

Despite Lesotho’s current mpox-free status, proactive measures are crucial to maintaining this record. To achieve this, the Ministry of Health and its partners must ensure effective communication that encourages citizens to adopt preventive behaviours, such as using condoms during sex.

To reinforce this message, the World Health Organisation (WHO) emphasised that while using condoms during sex can reduce the risk of contracting mpox, it does not “prevent spread from skin-to-skin or mouth-to-skin contact.”

Since having unprotected sex with someone infected with mpox can spread the disease, Africa Centre for Disease Control (CDC) Director General, Dr. Jean Kaseya, said it is crucial to address this issue without stigmatising individuals.

Dr. Kaseya acknowledged that communication in an appropriate manner around mpox remains a challenge in Africa.

“It is also a challenge on how to communicate in a more appropriate way to avoid stigma and to avoid to provide messages that are not appropriate in the context of mpox,” Dr. Kaseya said.

He added: “You know, today we must be clear that to get Mpox, it’s not just only a sexual transmission, it’s any contact, as Professor Muyombe said, any contact with someone who is infected can also lead for a person to get the disease.”

He emphasised that communicating that mpox cannot be transmitted through sex alone is crucial, stating, “otherwise, we are creating fear and stigma.”

Engage youth organisations

To enhance accurate messaging and combat misinformation, Dr. Kaseya highlighted the need to engage youth organisations, recognising their effectiveness in using modern communication tools.

“We need to involve youth organisations because they know how to transmit appropriate message using some social networks or using their mobile phone and other innovative ways. And we also agree with you, we learned from DRC.”

In light of this, Lesotho, which has struggled with communication in the past, can enhance its messaging and strategies by partnering more effectively with youth organisations, the media, and other stakeholders.

Health Minister, Selibe Mochoboroane, has encouraged his country’s nationals to be on the lookout for cautionary messaging from Ministry of Health’s officials, including prevention measures.

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Lesotho can also leverage its village health workers’ program to spread preventive messaging, a strategy that Dr. Kaseya from Africa CDC noted may be effective in the Democratic Republic of Congo.

“Yesterday (August 19, 2024), I was talking to the Minister of DRC, he was telling me about his vision in terms of community health workers, how he believes that by empowering community health workers, giving a digital tool to community health workers, helping them to be connected even to the data management system of the country will help to also fight other diseases. Because Mpox is not the only disease that we have,” Dr. Kaseya told the media on August 2024.

Dr. Kaseya’s emphasis on empowering community health workers aligns with recent efforts by the World Health Organisation (WHO). In July 2024, WHO reported that it had conducted event-based surveillance training for 3,455 community leaders and village health workers. The training, held in Mohale’s Hoek, Botha-Bothe, Qacha’s Nek, and Thaba-Tseka, aimed to improve the timely detection and response to health threats.

This training comes at a critical time, as the continent faces a growing number of mpox cases. As of August 19, 2024, there were 18,602 recorded cases of mpox in 13 African countries, with the Democratic Republic of Congo accounting for the highest number at 17,796 cases.

Close to home, Lesotho’s only neighbour, South Africa, had 24 cases of mpox. Mpox is a viral illness caused by the monkeypox virus, which comes in two types: Clade I and Clade II.

Understanding mpox transmission

In light of Dr. Kaseya’s call for appropriate messaging, it’s crucial to understand how the virus spreads. The World Health Organisation (WHO) explains that mpox can be transmitted to humans through physical contact with an infected person, contaminated materials, or infected animals.

“Common symptoms of mpox are a skin rash or mucosal lesions which can last 2–4 weeks accompanied by fever, headache, muscle aches, back pain, low energy, and swollen lymph nodes,” WHO explained.

It stated that laboratory confirmation of mpox is done by testing skin lesion material by PCR. Mpox is treated with supportive care, according to WHO.

“Vaccines and therapeutics developed for smallpox and approved for use in some countries can be used for mpox in some circumstances.

“Mpox can be prevented by avoiding physical contact with someone who has mpox. Vaccination can help prevent infection for people at risk,” WHO website read.

Meanwhile, Africa CDC said cross-border transmission to previously unaffected countries remains a concern. Lesotho’s proximity to South Africa, which has recorded 24 mpox cases, slightly increases its risk of also seeing cases.

Given this concern, Lesotho’s Health Minister, Selibe Mochoboroane, has advised Lesotho nationals traveling to countries with recorded mpox cases to stay vigilant. These countries include Burundi, Cameroon, Central African Republic, Congo Republic, Côte d’Ivoire, Democratic Republic of Congo, Ghana, Kenya, Liberia, Nigeria, Rwanda, South Africa, and Uganda.

In light of these concerns, Mochoboroane noted that a recent meeting between his ministry and other government departments assessed the country’s risk of mpox and found it to be moderate.

He told parliament that a recent meeting between his ministry and other government ministries assessed the country’s risk of mpox and found it to be moderate.

He noted that the country’s preparedness to fight mpox, in case it is detected, stands at 46 percent, which is 8 percent lower than the average readiness rate across the African continent.

“Key guidelines on how to combat this disease have been finalised and distributed to districts, health facilities, and ports of entry.

“Additionally, at least 200 health workers have received basic training on mpox, equipping them to quickly identify and manage cases if they occur. We have also informed our health partners as part of our preparedness strategy,” Mochoboroane told the National Assembly on August 20, 2024.

Vaccine availability

Just like with COVID-19 vaccines, the rise in mpox cases across Africa has highlighted the continent’s reliance on the developed world for life-saving vaccines. This situation underscores the urgent need for local vaccine production in Africa.

As Dr. Kaseya pointed out: “Without local manufacturing in Africa, we are exposed and we cannot continue like that.”

“…we need also to conduct appropriate studies in our context to know maybe that one can help us to readjust even doses or… other studies that we can conduct for appropriate vaccines,” Dr. Kaseya said.

While further studies are necessary to tailor vaccines to Africa’s needs, the Africa CDC is proactively moving forward with a plan to procure and distribute ten million mpox vaccine doses across the continent.

“And with this statement that came from Bavaria Nordic, you saw clearly that Bavaria Nordic is working with Africa CDC to ensure that Africans can have access to vaccine.

“And the 10 million doses we are talking is not a dream. We have a clear plan by end of 2025 to have these 10 million doses in Africa. And we thank also European Union through this emergency humanitarian leg era for partnering with Africa CDC to put a mechanism in place for the 215,000 doses that were procured,” Dr Kaseya said.

Africa CDC is collaborating with all African member states to strengthen the supply chain and enhance communication efforts, ensuring a smooth introduction of the mpox vaccine across the continent.

“The most important one for me as Director General of Africa CDC is to say every day, we need local manufacturing. And I want to recognise that and to thank Bavaria Nordic for accepting to do the tech transfer in Africa for Africa to manufacture the vaccine that will lower the price, and it will not compromise on the quality of the vaccine,” Dr. Kaseya said.

As Africa fights to combat and prevent the spread of the disease, countries like Lesotho must enhance their preventive measures to maintain a zero-infection status.