A year after mpox was declared a continental health threat, Africa’s response has shown encouraging momentum. An interim analysis of a new study by the Africa Centres for Disease Control and Prevention (Africa CDC) reveals strong public engagement, with above-average vaccine acceptance across all surveyed countries and firm trust in health information shared via television, radio and frontline health workers.
The study, conducted between December 2024 and August 2025 across nine countries — Burundi, the Central African Republic (CAR), the Democratic Republic of the Congo (DRC), the Republic of Congo, Kenya, Nigeria, Uganda, Rwanda and Côte d’Ivoire — involved over 17,300 quantitative surveys and 210 semi-structured interviews. Participants included health workers, traditional and religious leaders, community members, mpox survivors and their contacts, offering a rich and diverse perspective on the continent’s response.
Demographic data from the study paints a picture of inclusive participation. The median age of respondents was 34 years, with a slight majority being female (55%). Educational backgrounds were varied, with half of the participants having completed secondary education and nearly a quarter holding tertiary qualifications. Professionally, the sample included traders, businesspeople and unemployed individuals, reflecting a broad socioeconomic spectrum.
One of the most promising findings was the overwhelming readiness to receive vaccines. In all six countries covered in the interim analysis — Burundi, CAR, DRC, the Republic of Congo, Kenya and Nigeria — participants expressed eagerness to be vaccinated once doses became available. In Kenya and Nigeria, demand already exceeds supply, reinforcing Africa CDC’s call for 3.4 million additional doses to protect vulnerable populations.
The study also confirmed that trusted communication channels are playing a vital role. Across all study sites, radio, television and frontline health workers were consistently cited as the most reliable sources of information. In Burundi and Nigeria, exposure to mpox messaging was especially high — above 80% — demonstrating the effectiveness of targeted outreach efforts.
However, there are some worrying findings.
Despite strong engagement, knowledge gaps and behavioural challenges persist. In the Republic of Congo, only one in 10 respondents could identify more than three mpox symptoms. In the DRC, the epicentre of the outbreak, fewer than 10% of participants could both recognise symptoms and dismiss common myths. These disparities highlight the need for country-specific public education strategies rather than blanket messaging.
Myths and misinformation remain unevenly spread. Nearly 30% of respondents in CAR believed mpox was “not real,” compared to less than 15% in Burundi. Handwashing habits were inconsistent, with only 37% reporting they always wash their hands. Consulting health professionals was also low, with just 25% doing so regularly.
Stigma continues to be a major barrier. In Burundi and the DRC, more than 40% of participants said people with mpox should be discriminated against, leaving survivors isolated and vulnerable. In rural areas of CAR and the DRC, risky practices such as self-medication, close contact with wild animals and poor sanitation are widespread. In Kenya, spiritual interpretations of mpox are common, with some communities attributing the disease to curses or supernatural forces and seeking traditional healers before visiting clinics.
The findings point to a set of clear priorities: strengthening public education in misinformation hotspots such as CAR and the Republic of Congo, building partnerships with religious and traditional leaders to help align cultural practices with health advice, expanding vaccine and treatment access in high-demand countries like Nigeria and Kenya, and adopting policies to reduce risky animal–human contact in rural zones.
To address these gaps, the Mpox Incident Management Support Team (IMST), co-led by Africa CDC and the World Health Organization (WHO), is embedding behavioural insights into its response. Risk communication and community engagement are now integrated into surveillance, vaccination campaigns and outreach efforts. Weekly briefings continue to inform journalists across the continent, and messaging is being tailored to resonate with local beliefs and practices.
Professor Mosoka Fallah, who heads the IMST’s research pillar and led the study, said this was the first of its kind to deeply explore behavioural responses to mpox across multiple African countries. “Community trust and participation are our greatest assets in fighting the disease,” he said. “But to truly succeed, we must close knowledge gaps, tackle stigma and build local capacity to turn insights into action.”
His remarks were reinforced by Dr Jean Kaseya, the Africa CDC Director General, who stressed that understanding community behaviours is not peripheral but central to controlling outbreaks effectively. “This research shows that behavioural drivers are just as important as the biomedical response,” said Dr Kaseya. “If we do not address stigma and misinformation, we risk undermining the gains made.”
Dr Ngashi Ngongo, Incident Manager of the Mpox IMST, which coordinates the efforts of 28 partners, added: “We are incorporating these behavioural insights into our response, working with local leaders to ensure that our interventions resonate with communities. When we speak with one voice, we are stronger.”
Since declaring mpox a continental threat on 13 August 2024, the IMST has raised $1.2 billion against an initial $599 million appeal. The mechanism has become a model of coordination and is now guiding the cholera response in 23 African countries, linking outbreak control with broader water, sanitation and hygiene (WASH) interventions.
The interim analysis shows that Africa’s mpox fight goes well beyond vaccines and diagnostics. Communities are ready to embrace prevention and treatment, but lasting success will depend on overcoming stigma, countering misinformation, and addressing the socio-ecological drivers that fuel outbreaks.
