Africa CDC and WHO launch a joint continental response plan for mpox

As part of a new era for health emergencies on the African continent, the Africa Centres for Disease Control and Prevention and the World Health Organization’s regional office for Africa launched a joint plan for responding to the mpox emergency on the continent on Friday. It’s a six-month plan that aims to mobilize nearly $600 million. It’s the first time the agencies are using one continental coordination team, response plan, budget, and monitoring and evaluation framework in a major health response. This is part of yearslong efforts for the two organizations to work more cooperatively together. In the past, there have been challenges around duplications of efforts that led to inefficiencies, wasted resources, and confusion. During a press briefing, Dr. Jean Kaseya, Africa CDC’s director-general, said the two agencies are “co-creating” the coordination of this response. “We have a strong mechanism to avoid any kind of conflict, and we are working with all partners to ensure that … we are very well aligned,” he said. Over 24,850 suspected and confirmed mpox cases have been reported on the continent this year, with over 640 deaths. The plan is based on an estimated 92,000 cases and the vaccination of at least 10 million people over the next six months. The ongoing challenges in the response include weak surveillance of cases, limited laboratory capabilities, inadequate infection prevention practices, limited public awareness, inadequate community involvement, and a shortage of medical countermeasures, according to the plan. Delineating roles The new plan breaks down how the different organizations will delineate their roles at the continental level as they work to support African governments in managing outbreaks within their own borders. It has 10 pillars that outline the priorities of the response, including areas such as risk communication, surveillance, case management, vaccination, and research. Within the plan, countries are broken into four categories including those with sustained transmission, sporadic cases, those at high risk of cases, and others that should increase their preparedness more generally. The continental coordination and incident management is co-led by Africa CDC and WHO, with support from UNICEF. The detailed response plan assigns duties to specific individuals within organizations. For example, Africa CDC’s Chief of Staff Dr. Ngashi Ngongo is leading the coordination pillar alongside WHO’s Regional Emergency Director Dr. Abdou Salam Gueye. The response plan aims to leverage the specific strengths of the different organizations. For example, Africa CDC has political influence due to its position as a public health agency of the African Union. WHO, on the other hand, has a role internationally in setting standards and guidelines for disease control, and has well-established international partnerships. There are parts of the plan where the two intend to coordinate, whereas in other parts one organization is assigned to take the lead. The two aim to collaborate on standardizing data collection and rapidly sharing data between countries. They will also aim to work together with UNICEF on risk communications to ensure there’s consistent, culturally appropriate messaging between all partners. They will also jointly work to identify gaps in research. But Africa CDC will lead in areas such as training health workers around mpox management and enhancing laboratory capacity, whereas WHO will provide technical support and training materials. The plan names vaccination as a key part of the response and the “best solution” for the continent in managing the outbreak due to weak surveillance systems and limited diagnostic capacity. There have been delays in getting vaccines to the continent but DRC received 99,100 this week and Nigeria received 10,000 doses at the end of August. In this area, WHO aims to leverage its relationships with global manufacturers and donors to secure more vaccines, and Africa CDC is charged with ensuring that when they do arrive on the continent, they are equitably distributed across African countries based on risk and need. Budget breakdown The two organizations also aim to mobilize funding needed for this response, with joint fundraising efforts, as well as joint advocacy around ensuring equitable access to medical countermeasures such as vaccines. The nearly $600 million budget excludes the cost of vaccines, which depends on negotiations with manufacturers and will also include in-kind donations. About $330 million of the plan will be allocated to the response in 13 countries and readiness in 15 others. Another $270 million is earmarked for operational and technical support from partner organizations. “The way we are advocating for funding of this program is to ensure that each partner knows who is working where,” Kaseya said. DRC, where the majority of cases are, would get the largest portion of the funding, at $171.5 million, with Burundi and Central African Republic following, with $15.5 million, and $13.2 million, respectively. Countries without cases, but considered at risk, would generally get $1 million for preparedness efforts. WHO would receive the largest amount of funding of any organization, at $75 million, followed by $58.3 million for Africa CDC. Other organizations receiving funds are UNICEF, the International Organization for Migration, the International Federation of Red Cross and Red Crescent Societies, and the World Food Programme.