Responding to mpox in Africa: Vaccine strategy during sustained human transmission

Title : Responding to mpox in Africa: Vaccine strategy during sustained human transmission

Abstract:

Background: The 2024 resurgence of mpox driven by Clade Ib prompted declarations of a Public Health Emergency of Continental Security and a Public Health Emergency of International Concern. Unlike prior outbreaks, vaccines were mobilized within weeks. We describe progress, operational challenges, and policy lessons from Africa’s first year of coordinated continental mpox vaccination.

Materials and Methods: We conducted a descriptive analysis of vaccine policy, regulatory processes, allocation decisions, delivery data, pharmacovigilance reports, and monitoring dashboards from August 2024 to December 2025. Data sources included the Continental Incident Management Support Team (IMST), national reports from 16 countries, allocation records, and deployment tracking systems.

Results: By December 2025, over 5 million mpox vaccine doses (MVA-BN and LC16m8) had been shipped to 16 African countries. Fourteen countries-initiated vaccination, prioritizing contacts of confirmed cases and other high-risk groups in hotspot areas. Regulatory harmonization through AVAREF accelerated emergency authorizations, while global prequalification enabled multilateral procurement. Gavi-supported operational financing facilitated early rollout; however, broader operational funding gaps affected speed and scale in some settings. Vaccine utilization ranged widely (0–100%), influenced by epidemiologic context, competing outbreaks, surveillance capacity, and stigma affecting case detection and demand generation. No serious vaccine-attributable safety signals were identified.

Conclusions: The mpox response demonstrates strengthened regional coordination and faster vaccine access compared to prior emergencies. Future preparedness must integrate regulatory agility, proactive operational financing, surveillance strengthening, and context-specific effectiveness research to optimize outbreak vaccination in Africa.

Keywords: Clade Ib, Emergency use authorization, LC16m8, MVA-BN, Mpox vaccination.

Biography:

Charles Ugochukwu Ibeneme is a CDC-NFELTP–trained Field Epidemiologist and public health specialist with over 10 years of experience strengthening epidemic preparedness, surveillance systems, and emergency response across Africa. He currently serve at the Africa Centres for Disease Control and Prevention (Africa CDC) as the Continental Mpox and Cholera IMST Vaccine Pillar Lead, supporting vaccine access strategies, technical guidance, and coordination with Member States. His work includes supporting the allocation and deployment of over 5 million mpox vaccine doses across multiple countries. Previously based at the Southern Africa RCC in Lusaka, he provided regional technical assistance, program coordination, and implementation support to advance health security and immunization readiness.