KANYARUTSHINYA CAMP, Democratic Republic of Congo: Justine Munguiko could not recall the name of the disease she had been warned about. She knew only that her baby Fidele had painful sores similar to those suffered by other children at the displacement camp near the eastern Congolese city of Goma. Democratic Republic of Congo is the epicenter of an mpox outbreak that the World Health Organization declared to be a global public health emergency. Communities like Munguiko’s are among the most exposed and in need of support.
She and other mothers at the camp decided to treat their children in a traditional way for dealing with fevers and rashes: washing them in boiled salty water and rubbing their skin with the soft leaves of the Kitamatama plant. "This disease of skin lesions, comes from I don’t know where ... We’ve been told it comes after eating bushmeat, but neither I nor my child have eaten bushmeat,” the 24-year-old said, after trying to soothe her crying baby, who still had crusty sores on his wrists and feet.
As the international community struggles to source enough vaccines, Munguiko’s experience highlights the amount of work needed to ensure the most vulnerable have the knowledge and resources to protect themselves from the viral infection that is usually mild, but can kill. Communicating with people about what they should do is critical, said Ebere Okereke, associate fellow at Chatham House’s Global Health Program. "We need to get the right information out to the people who are immediately at risk,” she told Reuters.
There have been around 27,000 cases and more than 1,100 deaths, mainly among children, in Congo since the current outbreak began in January 2023. The virus has also spread to nearby countries. Around 750,000 people are living in camps after fleeing conflict, including seven-year-old Sagesse Hakizimana and his mother Elisabeth Furaha. He is one of more than 100 children to have been infected by mpox in one area near the city of Goma, in north Kivu, according to doctors.
"Imagine fleeing a war and then losing your child to this illness,” said Furaha, 30, rubbing ointment on her son’s rash and adding that his symptoms were easing. He was being treated last week in a repurposed Ebola treatment center. "We need a vaccine for this disease. It’s a bad disease that weakens our children.”
At Kanyarutshinya camp, residents gathered in an open area between the rows of tents to hear a health worker from aid organization Medair explain how to avoid infection. They received a colorful leaflet with pictures showing the risk of close contact with infected animals or people.
The challenge in Congo and other African countries is compounded by a lack of funding for research, said Helen Rees, co-chair of South Africa’s mpox incident management team. "We still globally do not have a good understanding of mpox ... outbreaks, how it spreads, how many asymptomatic cases we have for every case that we find with symptoms,” she told Reuters.
The country’s administration is another part of the problem. Grappling with conflict and multiple competing disease outbreaks, its government has yet to ask officially for vaccine supplies and took months to talk to donor governments. Its medicines regulator only approved the two main vaccines in June.
Denmark’s Bavarian Nordic, one of two key companies making mpox shots, and Congo are still discussing pre-shipment requirements necessary to ensure proper storage and handling, said a spokesperson for USAID. The vaccines have to be kept at -20C, for example. Bavarian Nordic said this week it needs orders now to produce vaccines in volume this year.
Even when shots arrive, questions remain about how to use them: Bavarian Nordic’s vaccine — the most widely used worldwide — is only available for adults. The other vaccine, made by Japan’s KM Biologics, can be given to children but is more complex to administer.
Adding to those questions, scientists have not yet agreed what groups should be vaccinated first, although a likely strategy is ring vaccination, where contacts of known cases are prioritized. "We saw with COVID-19 that the vaccine was available but the population didn’t want it,” says Jean Jacques Muyembe, co-discoverer of the Ebola virus and director of the Institut National de Recherche Biomédicale (INRB) in Kinshasa. — Reuters
He and other scientists said other public health measures like awareness raising in Africa and better diagnosis were also key to stopping the spread of mpox; vaccines are not the only solution.
Those on the ground are eager to learn more also. Camp resident Bizimungu Habimana, 46, examined the leaflet closely after the Medair presentation. "We thought there was no medicine or cure for this disease. I’m so glad to hear it’s curable,” he said. — Reuters