During the United Nations press briefing on March 24, officials revealed that health conditions in the Democratic Republic of Congo (DRC) have significantly deteriorated due to an increase in violence, mass migration and a growing number of epidemics. The DRC is now home to the second-largest displacement crisis in the world, second only to the ongoing crisis in Sudan.
One in four people in the region is facing extreme poverty and hunger, while 10 million people are displaced because of the ongoing conflict and severe flooding. The situation has created fertile ground for age-old diseases to reemerge.
The African country is now facing up to 50,000 cases of cholera and 28,000 cases of measles. All of this has added insult to injury to the nation’s seriously strained healthcare system.
The situation in DRC has concerned epidemiologists and forced public health officials to pay attention to the rising cases of MPox (formerly monkeypox) once again. Due to the continued violence, natural disasters, and the crowds of displaced individuals, experts are concerned that MPox cases will soon spill over into neighboring countries, putting all of central Africa at risk.
MPox is a very contagious orthopoxvirus similar to smallpox. The virus has an incubation period of five to twenty-one days, allowing those infected to potentially infect many people before symptoms emerge.
Unfortunately, MPox has a high mortality rate and lacks an effective antiviral, targeted vaccine, or even a reliable rapid PCR test. Researchers have had some success using the smallpox vaccine to provide limited prophylactic protection from mild exposures. However, there has yet to be an effective strategy for containing the virus and limiting its spread.
The MPox virus was first identified in humans in 1970 when it was found in a nine-month-old baby boy from the DRC. The virus was not confirmed in the United States until 2003, when officials confirmed that 47 patients had become sick due to exposure to infected prairie dogs, which had been infected by Gambian rats imported by an exotic pet store.
MPox is often forgotten in the West and has generated little concern in recent years. The Western world first paid attention to the virus during the late spring and summer of 2022 due to rising global cases outside Africa.
Concern reached a fever pitch after the World Health Organization reported on June 23 that there were over 3,000 cases of MPox in 47 countries. Shortly after that, on June 29, the US Center for Disease Control and Prevention reported more than 5,000 cases in 51 countries.
At the time, the majority of new cases were showing up in Europe and were linked to sexual activity.
The Centers for Disease Control and Prevention (CDC) reported 94,274 global cases, with only 178 deaths in 2022 and 2023. The U.S. had a staggering 32,125 cases, resulting in 58 deaths.
Because the mortality rate was relatively low in the West and the public inappropriately associated the virus with only sexual activity, policymakers in industrialized nations did not concern themselves greatly with the spread of the virus, and increasingly less attention was paid to DRC. Unfortunately, the situation in DRC has always been more vicarious than the officials and the media portray it to be.
The 2022-2023 global outbreak was caused by the Clade IIb variant, predominantly transmitted through intimate contact. A different version of the virus is currently plaguing central Africa.
Clade I of the virus is very virulent and carries a mortality rate as high as 10%. While the transmission mechanism is not well understood, it clearly goes beyond intimate contact.
The Center for Infectious Disease Research and Policy estimates that 2023 saw over 14,000 cases in the DRC and at least 654 deaths. Two thousand twenty-three significantly outpaced previous years, and the prevalence of cases has not slowed down. The first two and half months of the year saw at least 3,941 cases, which resulted in 271 deaths.
Most concerning is that children have been affected, accounting for two-thirds of all virus-related deaths. New strands of Clade I act like traditional childhood diseases, with transmission linked to general contact.
This should cause global health officials to pay more attention to what is happening in the DRC. The ongoing military conflict and humanitarian crises have created a massive petri dish, just begging the virus to spread and mutate. If this were to happen, it would be a matter of time before all of central Africa, if not the world, faced similar problems.
We need to remember the lessons of the COVID-19 pandemic. If a virus threatens people anywhere, it threatens people everywhere. This axiom demands that we call on our global leaders to pay attention to what is happening in central Africa.
As an ethicist, I prefer that our leaders unite to rally resources to combat the DRC’s humanitarian crises solely because it is the right thing to do. However, I also pragmatically know that ignoring the spread of MPox in Africa will most likely result in a far more significant loss of life, if not a global crisis.
Senior Staff Chaplain and Clinical Ethicist at the Baptist Health Medical Center in Little Rock, Arkansas.
