The Africa Centres for Disease Control and Prevention (Africa CDC) marked a crucial turning point in the continent’s public health trajectory by lifting the designation of mpox as a Public Health Emergency of Continental Security (PHECS). The shift from crisis response to sustained, systemic control encapsulates a new chapter for African health security, reflecting not only epidemiological gains but also a growing capacity for coordinated regional leadership and partnership.
The mpox crisis that surged across Africa in 2024 and 2025 was unprecedented in scale and complexity. By the end of 2024, the continent had reported 80,276 suspected cases and 1,340 deaths, figures that represented more than a five-fold rise in infections and a two-fold increase in mortality compared with 2023. The Democratic Republic of the Congo (DRC) bore a disproportionate burden, accounting for around 96 per cent of the reported cases and 97 per cent of deaths.
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This surge exposed long-standing structural weaknesses in disease surveillance, diagnostics and outbreak response. For decades, mpox, a zoonotic viral disease endemic to parts of West and Central Africa garnered limited global attention and investment, even as African nations faced recurrent outbreaks with insufficient access to vaccines, testing tools and therapeutics.
In August 2024, Africa CDC responded to this escalating threat by declaring mpox a PHECS, the first invocation of its expanded mandate under revised 2022 statutes. The declaration empowered the agency to coordinate continental action, mobilising resources, harmonising surveillance and strengthening laboratory networks.
The collective response spearheaded by Africa CDC and its partners represented a remarkable mobilisation of scientific, political and financial capital. Across affected regions, more than US$1 billion in financing was mobilised to bolster emergency operations and health system resilience. Surveillance capacities were digitised through community-anchored systems, and genomic sequencing was scaled up more than ten-fold, enabling more precise detection and monitoring of mpox transmission dynamics.
Vaccination campaigns delivered over five million mpox vaccine doses across 16 African countries, while a unified research agenda engaged more than 2,000 African and global scientists. By late 2025, these interventions had measurably altered the trajectory of the outbreak: suspected cases fell by approximately 40 per cent, confirmed cases by 60 per cent, and the case fatality rate among suspected infections declined from 2.6 per cent to 0.6 per cent.
These statistics demonstrate a significant turnaround from the height of the crisis earlier in the pandemic phase, underscoring the effectiveness of coordinated public health action. However, the decision to lift PHECS does not signal an end to mpox itself; rather, it reflects a transition toward sustained control and eventual elimination, with an emphasis on integrated systems and local ownership.
To guide this shift from emergency response to long-term stability, Africa CDC is launching the Mpox Transition Roadmap, a strategic blueprint designed to preserve hard-won gains while embedding stronger surveillance, vaccination, laboratory and research capacities into national health systems. The roadmap aims to prevent resurgence and improve health system resilience against mpox and other epidemic-prone diseases.
Core to this strategy is the recognition that sustainable health security requires comprehensive surveillance and early warning platforms, robust laboratory networks capable of genomic analysis, and risk communication strategies deeply rooted in communities. Vaccination continues to be a central pillar, informed by emerging evidence on effectiveness, immune duration and the optimisation of delivery to high-risk populations.
Moreover, the roadmap is aligned with broader efforts to strengthen Africa’s health sovereignty, including local vaccine manufacturing initiatives. The vision is to reduce dependency on external supplies and to foster a resilient continental supply chain for essential medical countermeasures. This aspiration reflects the wider Africa Health Security and Sovereignty agenda, which seeks to anchor prevention, preparedness and response capacities within continental institutions.
Lessons for Global Health
From a global perspective, the Africa CDC’s approach to mpox offers important lessons for pandemic preparedness worldwide. The rapid mobilisation of interdisciplinary expertise, the harmonisation of data and resources across borders, and the strategic alignment of emergency interventions with long-term health system strengthening exemplify a comprehensive public health model. These efforts echo the principles outlined in international health frameworks that prioritise equity, resilience and local leadership in epidemic response.
The Africa CDC’s experience also highlights the importance of sustained financing and political commitment in confronting emerging pathogens. While emergency declarations can catalyse immediate action, enduring resilience is rooted in investments that persist beyond the crisis horizon, from workforce development to infrastructure upgrades.
Sustaining Vigilance in Endemic Settings
Despite the progress, mpox remains endemic in several regions, and continued vigilance is essential. Health authorities must guard against complacency, particularly in contexts where underlying vulnerabilities, such as conflict, limited access to care and other infectious disease burdens, can fuel future outbreaks. The roadmap underscores the need for adaptive management, community engagement and continuous evaluation of public health interventions.
In this regard, the transition from emergency response to sustained control is not a retreat but an evolution, from reactive measures to proactive resilience. Africa’s experience with mpox serves as a testament to what comprehensive, locally led public health action can achieve when underpinned by scientific rigour, regional cooperation and a clear vision for long-term security.
At the heart of this roadmap lies a framework that resonates with global health priorities: Strengthened surveillance and early detection through embedded digital and community-based monitoring within national health systems. Integrated research and evidence generation to advance understanding of vaccine efficacy, immunity duration and transmission dynamics. Sustainable vaccination strategies ensuring equitable access and delivery tailored to high-risk populations.
Local manufacturing and supply chain resilience aimed at reducing dependency on external donors through in-continent production.
Community engagement and risk communication focused on building trust and fostering health literacy at grassroots levels.
This framework not only supports mpox control but also reinforces capacities relevant to other epidemic and pandemic threats, aligning Africa’s health security goals with global expectations for preparedness and resilience.
