South Africa makes strides in bid to contain mpox

Pretoria ‒ As the wider African region experiences an upsurge in mpox cases, South Africa's multi-pronged efforts to bring the outbreak under control are bearing fruit. On 14 August 2024, World Health Organization (WHO) declared mpox a public health emergency of international concern and subsequently issued a set of temporary recommendations to scale up the emergency response.

South Africa had previously reported five unlinked mpox cases in 2022. Having confirmed zero cases in 2023, the country has experienced a resurgence of the infectious disease in recent months, reporting 25 laboratory-confirmed cases and three deaths between 8 May and 6 September 2024. These cases have been reported in Gauteng, Western Cape, and KwaZulu-Natal provinces, with local transmission suggested for 24 cases and one imported case.

However, there has been a significant change in the epidemiological data in recent weeks, with just one new case and no deaths reported since 2 August 2024, compared to 12 cases and three deaths in June, so far, the peak of the current outbreak.

"With the support of partners including WHO, we have made significant progress in our efforts to contain mpox in the country," says Foster Mohale, spokesperson for South Africa's National Department of Health. "But we must not become complacent because viruses mutate from time to time. The recent detection of a new mpox case in Western Cape should be a strong reminder that we must all remain extremely vigilant."

To coordinate its response to the outbreak, the National Department of Health formed an mpox Incident Management Team comprised of experts from national and provincial levels and partners including WHO. In June, with WHO support, health authorities conducted two remote webinars on clinical management of mpox cases, training over 500 health workers and public health professionals.
The department has also activated provincial response teams to implement priority interventions in hotspots, deployed rapid response teams to support community surveillance and case management, and intensified targeted public awareness campaigns.

In addition to providing technical support and guidelines on mpox treatment to help ensure standardized patient care, WHO has donated 35 treatment courses of tecovirimat, an antiviral that is used to treat severe mpox cases in conjunction with symptomatic and supportive care. The Organization is supporting efforts to stockpile an additional 30 treatment courses of the medication for rapid deployment should further cases arise.

South Africa is one of 14 countries in the African region that will be financially supported by the Africa Centres for Disease Control and Prevention (Africa CDC) and WHO from September 2024 until February 2025 to draw up and roll out plans, including vaccination strategies, to continue its fight against mpox. The Mpox Continental Preparedness and Response Plan for Africa will see an estimated US$ 45.5 of a US$ 600-million total budget allocated to South Africa, most of which will be spent on the logistics of rolling out vaccines.

"WHO remains committed to supporting health authorities in containing the mpox outbreak through coordinated efforts in treatment, surveillance, and public awareness," says Dr Fabian Ndenzako, acting WHO Representative in South Africa. "I am pleased to see mpox control efforts targeting health workers, community members and key risk populations to prevent further transmission and manage this public health issue effectively."