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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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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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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