Mireille Efonge fell ill several months ago, experiencing fever and painful blisters. Unable to move, she was transported to a health center in Pakadjuma, a densely populated area in Kinshasa, the capital of the Democratic Republic of Congo. After an ambulance was called, her condition worsened with lesions appearing on her body. Eventually, she was diagnosed with mpox, a disease previously unfamiliar to her.
This incident occurred in August, at a time when mpox was still largely unknown in Kinshasa, a city of approximately 17 million residents. Researchers reflect on this period with a sense of loss, believing that containment of the virus might have been possible if timely actions were taken. However, it is now likely too late to effectively curb its spread.
The World Health Organization declared mpox a global public health emergency in August following the identification of a new variant in a remote mining town in eastern Congo. Since then, mpox has rapidly spread, particularly among displaced populations living in unsanitary conditions with limited access to healthcare.
Efforts to control the virus in Kinshasa have been slow and inconsistent, hindered by bureaucratic challenges and a disorganized response to the growing crisis. The country’s health system, characterized by underpaid workers and inadequate infrastructure, complicates the situation further. A vaccination campaign has been sluggish, with hundreds of thousands of doses remaining unused and no vaccinations administered to children, who represent a significant portion of those infected.
Historically, mpox has been a rural disease in Congo, primarily affecting isolated communities. The current health crisis began when a new strain, named Clade Ib, emerged last year, spreading through sexual contact and quickly gaining traction in other African nations as well as travelers in multiple countries.
This year, mpox cases in Congo surged to a record 53,000, with approximately 1,250 fatalities. In Kinshasa, the more contagious Clade Ib strain has particularly affected Pakadjuma, where economic activities often involve sex work. The response to the outbreak in this area has been inadequate, raising concerns about the potential broader impact on both local and global health.
Despite the arrival of vaccines and ongoing efforts, the vaccination campaign in Pakadjuma began only in early December, significantly delayed despite the availability of vaccine doses. As of last week, fewer than 54,000 doses had been administered across the country.
The facilities in Pakadjuma offer minimal support for the growing number of infected individuals, with several patients sharing rooms in suboptimal conditions for infection control. Many potential patients are reluctant to seek hospital treatment due to fears of stigma and isolation from their community.
Contact tracing efforts are also insufficient, with many individuals venturing away from home for extended periods, complicating the identification of those at risk. There is an increasing number of children affected, primarily through transmission from their mothers.
Additionally, bureaucratic issues continue to delay the arrival of a Japanese-made vaccine that is crucial for protecting children from mpox. Effective administration of this vaccine requires specific training and infrastructure that currently lacks adequate support.
Officials express concern over the outbreak, acknowledging that a more proactive response could have potentially mitigated its emergence. They emphasize the importance of addressing health issues in the Democratic Republic of Congo to prevent future outbreaks.