Africa's first year of joint mpox response reached 50 million people, but vaccines lagged

A year into Africa's coordinated response to mpox, the continent's public health agencies have built surveillance and laboratory capacity from a low base but still cannot get vaccine into arms fast enough — the central tension in a first-year evaluation published in BMJ Global Health on 15 September 2026 by the team that ran the response [s1].

After mpox was declared both a global and a continental public health emergency in August 2024, a Joint Incident Management Support Team (IMST), co-led by the Africa Centres for Disease Control and Prevention (Africa CDC) and WHO, was activated in Kinshasa, the capital of the Democratic Republic of the Congo, to coordinate the response [s1]. The review draws on key performance indicators across eight IMST pillars — coordination, surveillance, laboratory, case management, infection prevention and control, risk communication and community engagement, vaccination and research — using data from 28 African Union Member States between January 2024 and August 2025 [s1].

The epidemiological picture

Across those 28 countries, the response recorded 49,803 confirmed cases and 240 deaths, a case fatality ratio of 0.5% [s1]. That low ratio reflects both the nature of the circulating virus and, on the authors' account, the case management the response delivered, but it sits against an outbreak that spread across the continent from its epicentre in the eastern DRC. The IMST tracked US$977 million in resources mobilised for the response over the period, a figure that spans donor funding, in-kind support and domestic contributions across the 28 participating countries [s1].

What the system built

The clearest gains were in the plumbing of outbreak control — the surveillance, testing and communication infrastructure that determines whether cases are found at all. The response reported 87% surveillance completeness and 72% contact tracing completeness, and cut average laboratory turnaround time from more than five days to two [s1]. Diagnostic capacity was scaled dramatically in the worst-affected countries: testing sites in the DRC rose from two to 27, and in Burundi from one to 56 decentralised sites [s1].

Community engagement reached a wide audience. Risk communication activities reached 50 million people across 21 countries, and vaccine acceptance among high-risk groups nearly doubled over the period, from 44% to 87% [s1]. On the research pillar, the IMST reported that 24 of 26 planned multi-country clinical and operational studies — 92% — were implemented, alongside a 60% completion rate for the framework governing how research data and materials are shared across Africa [s1].

Where it fell short

The vaccination numbers are the review's sharpest finding, and the reason its own authors describe the last mile as an unresolved failure. Of 3.1 million vaccine doses delivered to the continent, only 938,000 — 32% — were actually administered [s1]. Nearly seven in ten doses that reached Africa were not given to anyone. The authors attribute the shortfall to structural weaknesses in last-mile delivery, and they flag two further persistent problems: contact tracing that was undermined by stigma and funding gaps, and regional research collaboration that remained weak and fragmented across competing national priorities [s1].

That gap between doses delivered and doses used is the kind of failure that recurs across emergency vaccination campaigns, and it is rarely a supply problem at that stage. Cold chain, trained vaccinators, community trust, micro-planning and the money to run all of it are what convert a warehoused dose into a protected person — and those are exactly the health-system foundations that an emergency footing tends to bypass rather than build.

The way forward the authors set out

The evaluation's conclusion is a governance argument as much as an epidemiological one. The joint IMST, co-led by Africa CDC and WHO, is described as a new benchmark for response governance, successfully mobilising resources and scaling diagnostics under unified continental leadership [s1]. But the authors argue the response now has to shift from emergency action to durable, sustained investment in national and sub-national health security, through a multisectoral, whole-of-government approach [s1].

The distinction matters because emergencies end and their infrastructure often dissolves with them. The 56 testing sites in Burundi and the doubling of vaccine acceptance are assets worth keeping; the 32% dose-administration rate is the warning that scaling supply without scaling delivery leaves most of the benefit on the shelf. Whether the surveillance and laboratory capacity survives the transition out of emergency financing — the moment when donor attention and dedicated funding recede — is, on the authors' framing, the test of whether the first year amounted to a lasting gain or a temporary one [s1].

This article is informational and is not medical advice.

Sources

• Mpox in Africa: one year continental response outcomes and way forward — BMJ Global Health, 15 September 2026.