By Adedapo Adesanya
The World Health Organisation (WHO) has announced that it was working with national health authorities in Africa to bolster surveillance and laboratory diagnosis to detect cases and deter a silent spread of the virus.
The continent as of June 28 has reported 1,821 cases in 13 countries of which 109 are laboratory confirmed in nine countries. The number of confirmed cases accounts for 2 per cent of the more than 4,500 confirmed cases globally.
However, there are a large number of suspected cases in the region, 81 per cent of which are in the Democratic Republic of the Congo, underlining the need for increased diagnostic capacity.
While all African countries have the polymerase chain reaction machines needed to test for monkeypox thanks to reinforced laboratory capacity in the wake of COVID-19, many lack reagents and in some cases training in specimen collection, handling and testing.
As a result, WHO is working to secure 60,000 tests for Africa, with around 2,000 tests and reagents to be shipped to high-risk countries and 1,000 to those facing lower risk.
Over the past months, five more African countries have received donations of reagents from partners, bringing to 12 the number of countries in the region with enhanced monkeypox diagnostic capacity. Another group of countries in West Africa will receive reagents after participating in a training.
Outside the six countries in Africa with a history of human transmission, monkeypox has also been reported in three countries which have not previously had any human cases. These include Ghana, Morocco and South Africa, which have confirmed the disease in two patients with no travel history, suggesting there is a high possibility of local transmission.
“The geographic spread of monkeypox to parts of Africa where cases have never been detected before is a worrying sign,” said Dr Matshidiso Moeti, WHO Regional Director for Africa. “It is critical that we support national efforts to boost surveillance and laboratory diagnosis, which are the cornerstones of disease control.”
To deepen the analysis of monkeypox transmission patterns, WHO is supporting countries to capitalize on the improved genomic sequencing capacity built during the COVID-19 pandemic.
Many years of research have led to the development of new and safer (second- and third-generation) vaccines for smallpox, some of which may be useful for monkeypox and one of which (MVA-BN) has been approved for the prevention of monkeypox. However, supplies are limited.
“What happened in the early days of the COVID-19 vaccine rollout when Africa watched on the sidelines as other countries snapped up limited supplies must not be allowed to recur. There are some signs that this is already happening,” said Dr Moeti. “The current global spotlight on monkeypox should be a catalyst to beat this disease once and for all in Africa. For this, we know vaccines are a critical tool.”
WHO is also working closely with the Member States and partners to define what type of coordination mechanism could be put in place to ensure fair access to vaccines. There are many regulatory, legal, operational, technical, and other issues to clarify before an allocation mechanism is fully operational.
With limited vaccines and antivirals, WHO does not recommend mass vaccination for monkeypox but rather targeted vaccination for people who have been exposed or are at high risk including health workers, laboratory personnel and outbreak team responders.
Aduragbemi Omiyale