A Review from Dr. Theresa Ngozi Agbonome
In recent years, monkeypox has been dubbed several names such as a forgotten disease, global health emergency, and wake-up call. The best description, however, may be: unfinished business, according to a broad new review published in the journal Current Medical and Drug Research.
Dr. Agbonome isn’t just documenting the ways in which mpox spreads in Africa; she’s also offering insights into its epidemiology. It tells the story of the virus’s presence in Africa, not as one of a hardy pathogen, but of weak infrastructure, labs lacking equipment, surveillance systems dependent on guesswork, and vaccines that rarely make it to those who need them most.
The Researcher
With both clinical medicine and public health experience, Dr. Agbonome’s background enables her to easily transition between the biology of the virus and the policy failures that have allowed it to continue spreading. The review is not a laboratory report but more like a blueprint for mobilization, an outbreak history, a diagnostic deep dive, a call to arms for governments, and health systems still playing catch-up.
Key findings of the Research
The virus is not playing the game as it used to: For decades, mpox was considered exclusively zoonotic, a disease that can be transmitted from rodents or bushmeat in isolated areas of Central and West Africa. Dr. Agbonome’s review makes it clear that its day is gone. There has been a growing trend towards outbreaks being fuelled by ongoing human-to-human transmission, often through skin-to-skin contact, respiratory droplets during close contact, or through contaminated surfaces, as well as in health-care-related environments where infection control measures are not in place.
The facts support this. A graph on the paper indicating the number of cases from 2019 to 2025 shows that the number of cases in Central Africa has risen from fewer than 200 cases to more than 1200 cases, and all of West, East, and Southern Africa followed a similar trend.
The Actual Outbreak Is Within The Health System
Whether it’s the simplest of concepts or the most complex, it’s this: mpox is not invincible; it’s winning because the systems supposed to prevent it are under-resourced.
Dr. Agbonome explains in exhaustive detail the failures of:
- Diagnostics: Real-time PCR testing is the gold standard method for confirming mpox, but many countries in Africa do not have the facilities, staff, and specimen transport systems to use this at scale, particularly in rural areas.
- Surveillance: In real time, the number of cases reported underreporting is widespread, especially in rural and conflict-affected areas, and the true extent and form of an outbreak is likely to be far larger than reported.
- Vaccines: Even if vaccination campaigns are present, cold chain logistics, lack of funding, and distribution problems prevent vaccines from reaching the highest-risk groups.
- Undertrained staff: Healthcare workers are frequently not trained in identifying mpox symptoms, especially when symptoms resemble other diseases such as chickenpox and herpes, making diagnosis and preventing spread of mpox difficult.
Factors such as the capacity for diagnostics, availability of vaccines, and readiness of healthcare workers are rated on a 5-point scale in a preparedness scorecard; the result is a grim picture overall, with most factors falling in the moderate to weak category in the region.
Who is at the Most Risk?
The population at highest risk, assuming that everyone exposed is at risk, is healthcare workers, hunters/wildlife handlers, rural communities, pregnant women, children, and immunocompromised individuals, according to Dr. Agbonome, who believes this should be prompting targeted instead of one-size-fits-all prevention efforts.
The COVID-19 Hangover
One of the more striking arguments in the paper is that Africa’s mpox response is repeating the early failings of COVID-19 when it comes to detection, lack of coordination across countries, and inconsistent risk communication. Dr. Agbonome doesn’t consider this a coincidence, however, but a lost opportunity, saying that the knowledge gained from the pandemic should have been incorporated into mpox preparedness plans by now.
A One Health Prescription
The review does not recommend a particular solution, but encourages a coordinated response to the One Health approach to public health by human medicine, veterinary and environmental monitoring. The fact that spillover of mpox is closely linked to deforestation, wildlife encroachment, and changes in animal reservoirs means that the disease does not just affect humans. Dr. Agbonome states that there is half a picture that is being overlooked.
Why it Matters Beyond Africa.
The spread of mpox isn’t just a regional story; it’s a preview. All of the factors that have contributed to its spread (urbanisation, climate change, low surveillance, global travel) are the very conditions that epidemiologists are concerned with for the next pandemic pathogen. In effect, Dr. Agbonome’s review deems tackling mpox response in Africa as one of the more effective approaches to preparing for the next outbreak.
The Bottom Line
Dr. Agbonome’s paper doesn’t have to provide easy answers because the strength of it lies in diagnosis, not prescription. Mpox is manageable. The tools to detect, treat, and contain it are largely in place. But this research has found there’s a lack of continued investment and coordination to actually get them in place where they’re needed.
Source: Agbonome, T. N. (2026). Management of mpox in Africa: Ongoing threat and epidemiological insights. Current Medical and Drug Research, 10(2), 1–13.
Disclaimer: This article is provided for general informational and educational purposes only. It does not constitute medical advice, diagnosis, treatment guidance, or official public-health advice. Information about mpox may change as new evidence emerges. Readers should consult qualified healthcare professionals and relevant public-health authorities for current guidance.
