From April 11-13, 2024, a ‘High-Level Emergency Regional Meeting on Mpox in Africa’ was convened by Africa CDC in collaboration with the Democratic Republic of Congo (DRC) and multiple other partners, including CEPI, WHO, UNICEF, INSP, and US Government among others. This report highlights key findings from 9 technical sessions.
The high-level ministerial meeting brought together over 05 Ministers of Health and delegates from 11 AU Member States (1)
To share the latest research and insights on Mpox, including its epidemiology, transmission, and prevention strategies (2)
To review and enhance existing response frameworks and collaboration mechanisms among affected countries (3)
To foster partnerships and coordinate efforts with international health organizations and donors for effective outbreak response and management including vaccination and, (4)
To develop a comprehensive action plan for Mpox surveillance, control, and prevention across the continent.

The high-level emergency meeting recognized the need for timely, accurate, and quality information on mpox situation in Africa to inform decision-making, program interventions, monitoring, and evaluations for the fight against mpox in Africa. The Ministers of Health of Angola, Benin, Burundi, Cameroon, Central African Republic, Congo, Democratic Republic of Congo, Gabon, Ghana, Liberia, Nigeria, Uganda, and partners emphasized the urgent need for strengthened preparedness and response to mpox in the African Union Member States, highlighting the need for cross-border integrated disease surveillance and a coordinated regional approach. It called for partners to harmonize support and interact with the African Taskforce for mpox coordination to fulfill mandates.

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Abstract

Assessing the prevalence of SARS-CoV-2 IgG positivity through population-based serological surveys is crucial for monitoring COVID-19 vaccination efforts. In this study, we evaluated SARS-CoV-2 IgG positivity within a provincial cohort to understand the magnitude of the humoral response against the SARS-CoV-2 vaccine and to inform evidence-based public health decisions. A community-based cross-sectional seroprevalence study was conducted, involving 10,669 participants who received various vaccines (two doses for BBIBP-CorV/Sinopharm, Covishield vaccine, and Pfizer/BioNTech, and one dose for Johnson & Johnson’s Janssen COVID-19 vaccine). The study spanned 16 provinces in the Casablanca-Settat region from February to June 2022, during which comprehensive demographic and comorbidity data were collected. We screened samples for the presence of IgG antibodies using the SARS-CoV-2 IgG II Quant assay, which quantifies antibodies against the receptor-binding domain (RBD) of the spike (S) protein, measured on the Abbott Architect i2000SR. The overall crude seroprevalence was 96% (95% CI: 95.6–96.3%), and after adjustment for assay performance, it was estimated as 96.2% (95% CI: 95.7–96.6). The adjusted overall seroprevalences according to vaccine brands showed no significant difference (96% for BBIBP-CorV/Sinopharm, 97% for ChAdOx1 nCoV-19/Oxford/AstraZeneca, 98.5% for BNT162b2/Pfizer-BioNTech, and 98% for Janssen) (p = 0.099). Participants of older age, female sex, those with a history of previous COVID-19 infection, and those with certain chronic diseases were more likely to be seropositive among ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm vaccinee groups. Median RBD antibody concentrations were 2355 AU/mL, 3714 AU/mL, 5838 AU/mL, and 2495 AU/mL, respectively, after two doses of BBIBP-CorV/Sinopharm, ChAdOx1 nCoV-19/Oxford/AstraZeneca, BNT162b2/Pfizer-BioNTech, and after one dose of Janssen (p < 0.0001). Furthermore, we observed that participants vaccinated with ChAdOx1 nCoV-19/Oxford/AstraZeneca and BBIBP-CorV/Sinopharm with comorbid chronic diseases exhibited a more pronounced response to vaccination compared to those without comorbidities. In contrast, no significant differences were observed among Pfizer-vaccinated participants (p > 0.05). In conclusion, our serosurvey findings indicate that all four investigated vaccines provide a robust humoral immune response in the majority of participants (more than 96% of participants had antibodies against SARS-CoV-2). The BNT162b2 vaccine was found to be effective in eliciting a strong humoral response compared to the other three vaccines. However, challenges still remain in examining the dynamics and durability of immunoprotection in the Moroccan context.

More at https://www.nature.com/articles/s41598-024-58498-6

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Abstract

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Mpox is endemic to 12 countries in Africa

Nachega said Africa has faced a long-standing unmet need for sustainable local diagnostic laboratories and research capacity for mpox. 

“MpoxReC will address these needs and provide outcome monitoring and surveillance across endemic African countries while simultaneously contributing to much-needed South-South, multi-disciplinary, and inter-professional research collaborations and capacity-building,” he said. He said the continent needs to share national and regional epidemic preparedness frameworks on the disease.

The research group, which includes global partners and African collaborators, will initially focus on Cameroon, the Central African Republic, the Democratic Republic of Congo, Ghana, Nigeria, and the Republic of Congo.  Professor Nadia Sam-Agudu will lead researchers at the University of Cape Coast Ghana, Professor Samuel Nakoune Yandoko will head the team at Pasteur Institute in Bangui, the Central African Republic, co-principal investigators Professor Jean-Jacques Muyembe and Professor Placide Mbala will represent the DRC’s Institute National Research Biomedical, Professor Dimie Ogoina from Niger Delta University Teaching Hospital will represent Nigeria, Cameroon’s Pasteur Institute research team will be led by Professor Richard Njouom and Congo will be led by Professor Francine Ntoumi from the Congolese Foundation for Medical Research. Expansion to other African countries will take place later.

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This training aims to bolster cross-border RCCE for coordinated emergency preparedness and response in the region. Participating countries include Ethiopia, Kenya, Rwanda, Somalia, South Sudan, Tanzania, and Uganda. Given the interconnectivity and the frequent emergencies in the region, including public health outbreaks such as Ebola, Marburg, cholera, and yellow fever among others, enhancing cross-border collaboration is crucial.

“In addressing the challenges of health security in region, it is crucial to recognize the imminent risks posed by dynamic cross-border movement,” stated Dr. Lul Riek, Regional Director for the Eastern and Southern Africa Regional Coordinating Centres at Africa CDC. “Limited cross-border coordination and weak mechanisms for RCCE compound these challenges. By strengthening our regional collaborations and enhancing our RCCE strategies, we can more effectively deliver timely, clear, and culturally sensitive information that empowers communities to take informed actions during health crises.”

Over the past few years, RCCE has been a critical component in outbreak response in East and Southern Africa, particularly to support the social and behavioural change needed for the uptake of health interventions and effective emergency readiness and response. Through RCCE, communities are kept informed, a coordinated system is in place to manage risks, and evolving needs during crises can be managed. This shift began with preparedness activities during the 2018 Ebola Virus Disease (EVD) outbreak. Since then, initiatives including the Collective Service, through the COVID-19 pandemic and subsequent emergencies in the region—have reinforced the critical role of collaboration between partners for the coordinated delivery of RCCE during health emergencies and the promise of leveraging community insights to inform and tailor other key pillars of a response.

“The urgency of our mission is heightened by a myriad of emergencies including missed vaccinations, conflict, climate sensitive diseases and climate-related disasters that increasingly threaten community resilience and livelihoods in the region. These disasters exacerbate vulnerabilities, particularly among dynamic and mobile populations and for children, presenting unique challenges to our response strategies. We need to continue to work together as response actors across pillars and borders to share and rapidly respond to recommendations emerging from community feedback and social science data, for more community-centred responses,” said Lieke van de Wiel, UNICEF Eastern and Southern Africa Deputy Regional Director.

Over the years, RCCE activities have evolved beyond one-way risk communication by Ministries of Health and partners. Today, the focus lies in coordinated approaches that engage affected communities, listen to their concerns, and harness both qualitative and quantitative data. Community feedback mechanisms, qualitative research, and data triangulation—across online/digital and offline channels—drive targeted responses. These efforts deepen our understanding of critical behaviors for outbreak response and promote preventive measures.

“Let us leverage the power of data and evidence-based practices to inform our decision-making processes and tailor our interventions including messaging to the specific needs of each community. By embracing innovation and utilizing new technologies, we can enhance our ability to gather, analyse, and utilize RCCE data effectively, thereby enhancing our overall response capacity.” Dr Daniel Langat, Head of Surveillance and Response, Ministry of Health Kenya.

By convening key government actors and public health partners, RCCE partners aim to develop standard operating procedures (SOPs), action plans, and training packages to improve RCCE readiness and data utilization for effective community-centered responses to outbreaks and disasters. This workshop is essential for ensuring the protection of children and vulnerable communities and maintaining essential services during emergencies.

Sophie Everest, UK-Public Health Rapid Support Team RCCE Specialist at the UK Health Security Agency said: “The UK-PHRST is delighted to be involved in this partnership of RCCE experts from across Eastern and Southern Africa to share technical expertise and facilitate scenario-based exercises to help strengthen community-led outbreak responses in the future. It is the first time Ministries of Health, Africa CDC, Red Cross and Red Crescent National Societies, WHO and UNICEF colleagues from across these countries have come together to discuss and plan how to prioritise this work, and we look forward to supporting these plans moving forwards.”

As emergency response partners in the region navigate a complex landscape of health emergencies, exacerbated by climate change and conflict, RCCE remains a critical tool in bridging knowledge, collaboration and action, in support of resilience, preparedness, and community well-being.

Africa CDC and UNICEF, in collaboration with IFRC, WHO and UK-PHRST as well as other partners, are committed to spearheading additional cross-border RCCE capacity-building workshops, thereby reinforcing resilience, preparedness, and community well-being throughout the region.

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For media enquiries please contact:

Communication & Public Information Directorate | Africa Centres for Disease Control and Prevention | Email: Communications@africacdc.org and AddisMH@africacdc.org

Sasha Surandran, UNICEF Eastern and Southern Africa, ssurandran@unicef.org

About Africa CDC: The Africa Centres for Disease Control and Prevention (Africa CDC) is a continental autonomous public health agency of the African Union that supports member states in their efforts to strengthen health systems and improve surveillance, emergency response, and prevention and control of diseases. Learn more at: http://www.africacdc.org

About UNICEF: UNICEF promotes the rights and wellbeing of every child, in everything we do. Together with our partners, we work in 190 countries and territories to translate that commitment into practical action, focusing special effort on reaching the most vulnerable and excluded children, to the benefit of all children, everywhere.For more information about UNICEF and its work for children, visit https://www.unicef.org/esa/. Follow UNICEF in Africa on Twitter and Facebook

About UK-PHRST: The UK-Public Health Rapid Support Team is a key international partner in infectious disease outbreak detection, prevention, preparedness and response; operational research; and capacity strengthening. We partner with low- and-middle income countries to support effective response to outbreaks before they develop into global health emergencies, and are able to deploy teams of public health specialists over a range of technical disciplines rapidly and at short notice to outbreak areas. We are an innovative partnership between the UK Health Security Agency and the London School of Hygiene & Tropical Medicine, funded with UK aid by the UK Department of Health and Social Care.

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NOTING WITH CONCERN the prolonged and ongoing epidemic of mpox in several Central and West African countries and the potential risk of transmission to neighbouring countries and beyond;
SERIOUSLY CONCERNED about the changing transmission dynamics, high mortality rate and transmissibility of the monkeypox virus, as well as the morbidity, mortality and social and economic impacts;
AWARE of the limitations on access to and acquisition of medical countermeasures, including diagnostics, treatments, vaccines and other tools for early detection, verification, care, treatment and prevention;
RECOGNIZING the common threat posed by the mpox outbreak to the health and economic security of the populations of the Central and West African regions and the urgent need to address this common threat by all member states of the African Union;
ACKNOWLEDGING the existing frameworks, protocols, strategies and agreements for cross-border solidarity, collaboration and coordination on infectious disease issues, including:

• The Constitutive Act of the African Union (2000);
• The Protocol Relating to the Establishment of the Peace and Security Council of the African Union (2002);
• The International Health Regulations (2005); and, the African Union Declaration on Accelerating the Implementation of IHR in Africa (2017);
• The WHO Regional Strategy for Health Security and Emergencies, 2022-2030; and WHO African Region’s Integrated Disease Surveillance and Response Strategy, 2020-2030;
• The Framework for Collaboration Between WHO and the African Union Commission on the establishment and operationalization of Africa CDC to improve health security in Africa (2016)
• The Agreement Establishing the African Continental Free Trade Agreement (2018);
• The Memorandum of Understanding between the Commission of the African Union and the World Health Organization (2019);
• The Amended Statute of the Africa Centres for Disease Control and Prevention (2022);
• The Standing Recommendations for Mpox issued by the Director-General of the World Health Organization (WHO) under the International Health Regulations (2005) (IHR) to all Member States (2023).

CONVINCED of the urgent need to strengthen preparedness and response to mpox at points of entry and within the respective national borders of AU Member States, including the need for a coordinated regional and sub-regional approach to prepare and respond effectively and rapidly to mpox and other similar epidemics;
NOTING the need for a strong national focus on the recommended comprehensive interventions (surveillance, contact tracing, community engagement, vaccination and targeted research);
COMMENDING national governments in the region for their ongoing reflections and analyses of the situation, as well as their efforts to respond to mpox epidemics, including collaborative initiatives on mpox research to fill knowledge gaps;
COMMENDING Africa CDC, WHO, UNICEF, US CDC, USAID, CEPI, Wellcome Trust, GAVI and other technical and financial partners for their support to the mpox response, including cross-border collaboration between affected and at-risk neighbouring countries;

Collectively, we resolve and commit our governments and institutions to:
1. PROMOTE a ‘One Health’ approach and inclusive, community-centered response mechanisms, including:
a. Strengthen response efforts in our countries and give them the resources and political commitment they deserve;
b. Develop and implement national multi-sectoral mpox plans, outlining critical actions to control mpox in all contexts;
c. Establish multi-sectoral coordination and accountability mechanisms that include other ministries and partners;
d. Establish and develop surveillance and laboratory diagnostic capabilities to improve epidemic detection and risk assessment;
e. Engage in further research to better understand the epidemiology and transmission dynamics of mpox in our countries, including sexual transmission.
f. Provide optimally integrated and stigma-free clinical care for mpox, including access to specific treatment and support measures to protect healthcare workers and caregivers, where appropriate;
g. Collaborate and accelerate research and development and regulatory processes for the development, and ensure equitable access to safe, effective and quality countermeasures, including vaccines, diagnostics and therapeutics for affected populations including children;
h. Develop strategies for the use of new technologies to facilitate sample transport (drones, etc.);
i. Strengthen organized and structured national laboratory networks; and more rational detection procedures to improve biomonitoring, biosafety and biosecurity.
2. UNDERTAKE actions to facilitate cooperation and collaboration between all African Union Member States, in particular countries affected by an mpox outbreak and other neighbouring countries, for mpox preparedness and response, including:
a. Real-time sharing and digitization of epidemiological and laboratory surveillance data and other relevant reports;
b. Cross-border collaboration and coordination in mpox preparedness and response;
c. Sharing of technical expertise and other resources required for mpox preparedness and control;
d. Joint cross-border planning and implementation of Mpox preparedness and response activities, including risk communication and community engagement campaigns, including among key populations;

e. Sharing of information on potential threats to health security arising in areas affected by mpox outbreaks;
f. Monitoring the movement of people, animals and goods across national borders in accordance with the International Health Regulations (2005);
g. Capacity building of human resources, including joint training, learning exchanges and benchmarking visits, as well as simulation exercises;
h. Development of legal and regulatory processes and logistical planning for rapid cross-border deployment of public health experts and medical personnel for the mpox response.
3. FACILITATE technical support through Africa CDC and WHO mechanisms at various levels, including headquarters offices (Africa CDC and WHO), regional collaborating centres, regional offices and country offices.
4. EXCHANGE information rapidly on preparedness and response matters of common interest in line with the IHR (2005), in order to maintain the peace, security and prosperity of affected Member States and the Continent as a whole;
5. DECIDE to establish the Africa Taskforce for Mpox Coordination among Member States affected and at-risk of mpox to:
a. Facilitate the strengthening of preparedness and response capacities to mitigate the impact of mpox in Africa and beyond;
b. Strengthen rapid epidemic response, effective surveillance, capacity building of national laboratories and engagement with affected communities
c. Develop a common regional and national roadmap outlining mpox prevention, detection and control;
d. Prioritize scientific research and evidence synthesis for a better understanding of the disease, and support evidence-based decision-making for disease prevention and control.
6. REQUEST the African Union Commission, Africa CDC and WHO to jointly facilitate coordination of the Africa Taskforce for Mpox Coordination;
7. CALL UPON ALL partners to harmonize support to Member States in the fight against mpox by interacting with the African Taskforce for Mpox Coordination to ensure that each fulfills the mandates given to them at this meeting.

Kinshasa, 13 April 2024
Democratic Republic of Congo

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With its population expected to double to 2.5 billion people by 2050, Africa has been disproportionally affected by the impacts of climate change. Africa contributes only 4% of the global carbon emissions; however, 7 out of the 10 countries most vulnerable to the impacts of climate change globally are located in Africa. High- income and upper middle- income countries contribute to 87% of global carbon emissions but are less vulnerable to the impacts of climate change.

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The CBVs who are deployed for three (3) months, are trusted members of their communities and will serve as a vital link between community members and healthcare providers, offering support in health education, hygiene and health promotion, community mobilisation, psychosocial support, including stigma prevention, as well as dis/misinformation management at the community level.

Speaking on behalf of the Africa CDC Director General Dr Jean Kaseya, Dr Lul Riek mentioned that the call for community health workers is in line with the Africa Union Heads of State and Government decision to expedite recruitment, training and deployment of 2 million Community Health Workers (CHWs) across the continent. ‘‘This is also consistent with the Africa CDC New Public Health Order that calls for a strong health workforce development and robust network of community healthcare workers,’’ he said.

This deployment marks a pivotal step in Africa CDC’s commitment to promoting health equity and empowering communities to take charge of their health. Through personalised interactions at the community level, CBVs will connect individuals with healthcare services, breaking down barriers to access and information and ensuring that community members receive timely care and treatment. CBVs will be disseminating information on cholera preventive measures and good hygiene practices, thereby empowering community members to participate actively in the fight against cholera.

Officiating the CBVs deployment, Honourable Sylvia Masebo, the Minister of Health of the Republic of Zambia, noted that engaging the communities on Cholera is highly critical and significant because all outbreaks start within the communities and end with active participation and engagement of community members.

The engagement of volunteers, recruited from within their communities, highlights the transformative potential of community-led solutions and reflects Africa CDC’s dedication to strengthening health systems across the continent.

In addition, Africa CDC support to the cholera response efforts in Zambia includes the deployment of 15 technical assistance officers; production of information, education and communication materials; strengthening laboratory capacity for genomic sequencing; training of 50 healthcare workers on sample collection and referral; recruitment and deployment of 150 clinical management staff including 20 Medical Officers, 100 Nurses, 4 Laboratory Scientists, 16 Clinical Officers, and 10 Environmental Officers for the next three months.  Africa CDC will similarly support with the procurement of medical supplies, including Oral Rehydration Salts (ORS) and disinfectants as well as strengthening cross-border surveillance to circumvent further spread control of the outbreak.  

For more information:

Dr. Merawi Aragaw| Head of Division for Surveillance and Disease Intelligence | Africa Centres for Disease Control and Prevention| African Union| email: merawia@africacdc.org| M: +251912611294 Website: www.africacdc.org| Addis Ababa| Ethiopia| Facebook | Twitter

For media inquiry:

Directorate of Communication and Public Information|Communications@africacdc.org| Website: www.africacdc.org | Addis Ababa| Ethiopia| Facebook | Twitter

About Africa CDC The Africa Centres for Disease Control and Prevention (Africa CDC) is a continental autonomous Public Health agency of the African Union which supports Member States in their efforts to strengthen health systems and improve surveillance, emergency response, prevention and control of diseases. For more information, visit https://africacdc.org

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