Title : Mpox vaccination in Africa: One year on – lessons and milestones from the continental response
Abstract:
Introduction:
Mpox, long endemic in Central and West Africa, re-emerged as a continental threat during 2022–2024, with over 45,000 cases and nearly 1,500 deaths across 12 countries. The surge in Clade Ib cases in DRC and beyond led Africa CDC to declare a Public Health Emergency of Continental Security (PHECS), swiftly followed by WHO’s PHEIC. Vaccination became the cornerstone of the joint continental response. To help ensure a fair, equitable and efficient distribution of mpox vaccines, the Technical Review Committee (TRC) was established by the Access and allocation mechanism to review country plans and offer recommendations for quality operational plans and advise on the allocation of doses between countries to the continental mpox incident management support team (IMST). This paper aims to explore the lessons learnt and milestones during one year of equitable distribution of mpox vaccines on the continent.
Methods:
A continental Incident Management Support Team (IMST), co-led by Africa CDC and WHO with UNICEF and Gavi, coordinated vaccine access, allocation, and deployment. Data were collected from national vaccination plans, regulatory processes, and country dashboards between August 2024 - August 2025. Results: By July 2025, over 2.1 million doses were allocated over five rounds by the Technical Review Committee of the Access and Allocation Mechanism based on country requests and vaccination plans, and above 1.5 million doses of MVA-BN shipped to 12 countries, including DRC, Nigeria, Rwanda, Uganda, and Liberia. By Mid-August 2025, 9 countries had rolled out Mpox vaccination on the continent prioritizing high-risk populations which included health workers, case contacts, and vulnerable groups. Targeted rollouts and dose-sparing strategies were adopted to maximize scarce supply. Regulatory alignment through AVAREF accelerated emergency approvals, while innovative community engagement helped counter hesitancy. Despite progress, challenges included global vaccine shortages, funding delays, and logistical bottlenecks.
Conclusion:
One year on, Africa’s mpox vaccination campaign demonstrates both progress and fragility. Regional solidarity, dose-sparing innovation, and integration with existing health systems strengthened the response. However, supply insecurity and funding gaps remain critical barriers. Lessons from this effort which centered on community trust, agile logistics, and strong regional coordination remain pivotal not only for mpox control but also for building Africa’s preparedness against future epidemics.
