In recent years, the resurgence of Mpox (monkeypox) has underscored the urgent need for effective, regional surveillance systems, especially in Central Africa where the virus is endemic. The establishment of a regional Mpox surveillance network has provided a groundbreaking framework to improve disease monitoring, data collection, and response strategies. Spearheaded by Vakaniaki, Merritt, Linsuke, and colleagues, this initiative marks a pivotal turning point in managing zoonotic outbreaks in a region historically vulnerable to infectious diseases. The network’s formation has integrated technical, logistical, and epidemiological advances, providing public health officials with the tools necessary to curb Mpox transmission and mitigate its societal impacts.
Mpox’s biology and transmission dynamics are complex. The virus belongs to the Orthopoxvirus genus, sharing similarities with smallpox but presenting unique epidemiological challenges. It is primarily a zoonotic pathogen, prevalently harbored in various wildlife species indigenous to Central Africa, including certain rodents and non-human primates. Human infections arise sporadically, often linked to direct contact with infected animals or contaminated materials. However, human-to-human transmission, particularly through respiratory droplets or close physical contact, has become an increasing concern in densely populated areas. The surveillance network aims to track such transmission routes meticulously to enable early outbreak detection.
Building this regional network required overcoming significant obstacles. Historically, public health infrastructure in Central African countries has been under-resourced, fragmented, and challenged by political and geographic complexities. Cross-border collaboration is indispensable in controlling Mpox since virus transmission does not respect national boundaries. The surveillance effort harmonizes data standards and reporting mechanisms among multiple countries, creating a shared platform that allows real-time data exchange and joint outbreak investigations. This harmonization facilitates a more coherent and timely regional response that could significantly limit disease spread.
Technological innovations are at the heart of this surveillance system. The network utilizes advanced molecular diagnostics such as polymerase chain reaction (PCR) assays capable of detecting viral DNA with high sensitivity and specificity. These diagnostics are deployed strategically in local health centers equipped with portable and user-friendly devices that empower frontline health workers. Additionally, geospatial mapping tools analyze outbreak epicenters and identify transmission hotspots. This spatial analytical capacity enhances resource allocation, directs containment interventions, and supports risk communication campaigns targeting vulnerable communities.
Importantly, the network integrates community engagement as a core principle. Local populations are educated on Mpox symptoms, prevention strategies, and the importance of prompt reporting. Community health workers serve as critical links between surveillance teams and at-risk households, enabling immediate case identification. Educational outreach also dispels misinformation and stigma that may otherwise hinder timely care-seeking behavior. Thus, the surveillance network goes beyond pure data collection—it fosters a resilient public health ecosystem rooted in participatory practices.
Another technical dimension is the development of interoperable digital platforms for data management. These platforms standardize case definitions, laboratory results, and clinical observations, channeling them into centralized servers accessible to all participating countries. Machine learning algorithms embedded within the platform analyze trends and predict potential outbreak flare-ups. Early warning alerts triggered by anomalous patterns prompt rapid deployment of field investigation teams. This integration of artificial intelligence represents a cutting-edge adaptation to resource-constrained settings, maximizing the efficacy of limited epidemiological personnel.
Surveillance data generated by the network has already yielded critical insights into Mpox ecology in Central Africa. The pattern of seasonal outbreaks appears closely linked to environmental factors such as rainfall cycles, wildlife population dynamics, and human agricultural activity. Understanding these contextual drivers enables tailored intervention timing, such as intensified surveillance following heavy rains when animal incursions into villages increase. Furthermore, phylogenetic analyses of isolated viral strains highlight genetic diversity and mutation rates, shedding light on possible evolutionary trajectories and vaccine efficacy considerations.
The network’s collaborative model extends beyond governmental health agencies, embracing academic institutions and non-government organizations. Research partnerships facilitate capacity-building workshops and training in biosafety, sample collection, and clinical management protocols. Moreover, shared data repositories have accelerated scientific publications and policy recommendations that shape regional and global Mpox control guidelines. This inclusive approach ensures that the network evolves adaptively, responding to emerging challenges and integrating new scientific knowledge as it becomes available.
Fiscal sustainability is a prominent concern for any surveillance operation in low-resource settings. To address this, the network has explored innovative financing mechanisms including international aid coordination and public-private partnerships. Cost-effective solutions such as local production of diagnostic reagents and utilization of mobile phone-based reporting tools reduce operational expenses. Such economic considerations ensure that the surveillance efforts are not transient emergency responses but enduring components of the public health infrastructure.
Ethical considerations are systematically embedded within the network protocols. Confidentiality of patient information and informed consent for sample collection are rigorously maintained. The network also promotes equitable access to diagnosis and care, ensuring marginalized populations are not excluded. These ethical safeguards enhance trust in the surveillance system, which is crucial for maintaining community cooperation and accurate data reporting.
Looking forward, expansion of the surveillance coverage area and incorporation of additional zoonotic diseases are planned. The framework established for Mpox offers a scalable template for integrated disease surveillance and response (IDSR), potentially encompassing other viral hemorrhagic fevers and emerging pathogens of public health concern. By continuously refining diagnostic tools, analytical capacities, and field coordination, the network aims to contribute substantially to regional pandemic preparedness and global health security.
This regional network serves as a replicable model demonstrating how endemic regions, despite infrastructural limitations, can mount sophisticated responses to neglected tropical diseases. Its success is a testament to multi-sectoral collaboration, cutting-edge technology adaptation, and empowered communities working synergistically. As Mpox continues to pose threats globally due to international travel and ecological changes, such dedicated surveillance networks are essential fortresses against unchecked viral spread.
The impact of this initiative extends beyond purely epidemiological outcomes. By strengthening healthcare delivery and data systems, the network bolsters broader health system resilience. Enhanced laboratory capacity, communication networks, and trained personnel provide foundational benefits applicable to other health priorities. Policymakers have taken notice, increasingly investing in surveillance as a pillar of health security strategies that protect societies from unpredictable zoonotic spillovers.
In summary, the establishment of the regional Mpox surveillance network in Central Africa represents a landmark achievement in infectious disease control. Its comprehensive approach—merging technical, social, and policy elements—addresses the multifaceted challenges of an endemic zoonosis in a resource-limited context. Continued support and expansion of this network are vital steps forward in global efforts to prevent future outbreaks, safeguard vulnerable populations, and stabilize health systems threatened by emergent viral infections.
Subject of Research: Establishment and implementation of a regional Mpox surveillance network in Central Africa
Article Title: Establishment of a regional Mpox surveillance network in Central Africa: shared experiences in an endemic region
Article References:
Vakaniaki, E.H., Merritt, S., Linsuke, S. et al. Establishment of a regional Mpox surveillance network in Central Africa: shared experiences in an endemic region. glob health res policy 10, 14 (2025). https://doi.org/10.1186/s41256-025-00408-y
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