Attachments
SITUATION ANALYSIS
The continental Mpox preparedness and response plan specifically targets migrants, Internally Displaced Persons (IDPs), highly mobile populations, and cross-border communities across the African continent. The migration in Africa involves large numbers of international migrants moving both within and from the region. Over 21 million Africans were living in another African country and Africa hosted around 25.4 million international migrants in 2020. As of 2020, the East Horn and Southern Africa region hosts 12.2 million international migrants, representing nearly half (48%) of all migrants in Africa, the West and Central Africa (WCA) region hosts 9.8 million international migrants of which 83 per cent come from another country in the region, and 3.2 million international migrants in North Africa region.1,2 This significant migratory presence is due to the region’s role as an origin, destination, and transit hub, driven by its rapidly growing economies and strategic geographical position, as well as displacements triggered by conflicts and natural disasters. Nevertheless, forced displacement remains a major phenomenon in the continent, with almost 11 million displaced individuals within WCA in 2024 due to conflicts or disasters.
The interconnection across the African continent poses significant challenges for managing communicable diseases. Mobility is known as a determinant of health and the recent COVID-19 outbreak has demonstrated that mobility contributes to the geographical spread of disease both within and between countries. Inadequate public health systems, coupled with limited border management capacities, can hinder effective disease prevention and control. Marginalized and hard-to-reach populations, including refugees, displaced persons, highly mobile populations, and migrants, often face significant barriers in accessing essential healthcare services, further increasing their vulnerability to health risks.
The African continent is currently grappling with several urgent public health threats, especially disease outbreaks including Mpox. Mpox is an infectious disease caused by the Orthopoxvirus (OPXV). Known variants of MPXV are divided into two clades, Clade I (formerly known as the Congo Basin clade) and Clade II (formerly known as the West African clade). Since the virus was first discovered in 1958 and the first case was reported in the Democratic Republic of the Congo (DRC) in 1970, Mpox has mainly been considered a zoonotic disease in the forested areas of Central Africa, causing limited epidemics in rural areas but the animal reservoir of the virus remains unknown. A global outbreak of Clade II began in 2022 and continues to this day including in some African countries. Clade Ib has recently emerged in Eastern regions of the DRC and neighboring countries and its recent detection in Sweden and Thailand3 .
In August 2024, the Africa Centre for Disease Control and Prevention (Africa CDC) declared the ongoing Mpox outbreak a Public Health Emergency of Continental Security (PHECS) in a press release4 , marking the agency’s first such declaration since its inception in 2017. This decision highlights the severity of the outbreak across the continent and the concerns of the spread of Mpox to previously unaffected countries through cross-border transmission. During the same period, the World Health Organization (WHO) reported in a press release5 that the African region is experiencing an unprecedented increase in Mpox cases since the start of 2024 and declared Mpox outbreak a Public Health Emergency of International Concern (PHIEC) under the International Health Regulations (IHR) (2005). The WHO highlighted that the DRC is experiencing one of the largest Mpox outbreaks globally, which accounts for more than 82 per cent of the reported cases in 2024 due to the spread of a new variant (Clade Ib), followed by Burundi at 14 per cent. As of 16 October 2024, 18 Member States (Burundi, Cameroon, Central African Republic, Côte d’Ivoire, Congo, DRC, Gabon, Guinea, Kenya, Liberia, Morocco, Nigeria, Rwanda, South Africa, Uganda, Zambia, Zimbabwe) across Africa have reported 8,540 confirmed cases, including 33 deaths since the beginning of this year. Among the reported countries, new cases have emerged in nine countries (Burundi, Côte d’Ivoire, Gabon, Guinea, Kenya, Rwanda, Uganda, Zambia and Zimbabwe), which were previously unaffected, the spread has been contributed to cross-border infection6 .
Many countries in the continent are particularly vulnerable to Mpox transmission due to factors such as inadequate border health capacity, weak health infrastructure, limited resources, and insufficient awareness and prevention measures. These vulnerabilities heighten the risk of cross-border transmission, making it imperative to enhance the region’s ability to detect, prevent, and respond to the spread of Mpox effectively.
This preparedness and response plan aims to prepare for and respond to the anticipated surge in Mpox cases and mitigate the spread and the likely negative impacts of the virus spreading across the continent. The funds will be allocated to address the health needs of migrants, IDPs, highly mobile populations (including truck, bus, motorcycle drivers, taxi drivers and sex workers), and affected host communities, enhance disease surveillance, support contact tracing, improve risk communication and community engagement, strengthen response at border points, improve prevention and response efforts, and strengthen multi-sectoral cross-border coordination across the continent in order to promote one health approach.
The International Organization for Migration (IOM) is committed to ensuring that its response is centered on the needs, rights, and capacities of affected populations. The Accountability to Affected Populations (AAP) framework is integral to IOM’s preparedness and response plan, ensuring that its actions are guided by principles of transparency, participation, and responsiveness.
Protection from Sexual Exploitation, Sexual Abuse and Sexual Harassment (PSEAH) is a top priority for IOM, and the Organization consistently demonstrates its commitment to addressing it, both internally and through the Inter-Agency Standing Committee (IASC) and United Nations (UN) system. To protect affected populations from Sexual Exploitation and Abuse (SEA), IOM will implement various measures, including integrating SEA risk mitigation into all response sectors, enhancing the capacity of frontline workers and partners, establishing safe and accessible complaint mechanisms, participating in inter-agency PSEA responses, and ensuring that SEA and Gender Based Violence (GBV) survivors receive quality and timely support.