It started as a slight rash on little Joshua’s chest — nothing alarming, or so his mother Monique Baloji thought.

Her initial suspicion that Joshua was having an allergic reaction turned into panic when the three-year-old’s body was covered in painful lesions.

The toddler also ran a temperature, crying constantly and refusing to eat. 

“I had never heard of mpox before,” Monique, a native of South Kivu in the Democratic Republic of Congo (DRC), tells TRT Afrika of her son’s diagnosis. “By the time we got to the hospital, my baby was so weak. When doctors said it was mpox, I felt my world collapse.” 

Across Africa, mpox has gone from a viral affliction restricted to pockets of the continent to a larger malaise, spreading to new regions and leaving families grappling with its painful, sometimes disfiguring effects.

The Africa Centres for Disease Control and Prevention (Africa CDC) and the World Health Organisation (WHO) have updated their Continental Response Plan, intensifying efforts to control outbreaks while expanding vaccination and long-term health strategies.

Continental scourge

Historically transmitted from infected animals, recent African outbreaks have seen a surge in human-to-human transmission. The disease causes fever, swollen lymph nodes and skin lesions that cause scarring.

In 2022, a variant known as “clade IIb” began spreading globally, mainly through sexual contact. By the end of 2023, a more aggressive strain, “clade lb”, emerged, transmitting not only through sexual contact but also within households.

In August last year, the Africa CDC declared a “Public Health Emergency of Continental Security” after the new strain emerged in the DRC and spread to neighbouring countries.

Since then, 28 nations worldwide have reported cases, with Africa bearing the heaviest burden of the potentially fatal disease.

Outside Africa, most cases remain travel-related. Within the continent, local transmission has surged, also reaching nations like Zambia and Tanzania that hadn’t previously reported mpox cases.

Misinformation cycle

In Nairobi, a young mother contracted mpox from her husband, a truck driver who travels across East Africa.

“At first, the neighbours avoided us. They thought we were cursed. Even family stopped visiting,” the 32- year-old Kenyan tells TRT Afrika.

Frank Lubega, a Ugandan university student, still bears the physical and emotional scars of mpox.

"For weeks, I couldn’t look in the mirror," he says. "The worst part wasn’t the pain – it was how people looked at me."

Dr Fanuel Odongo, a public health official in Kenya, blames misinformation for the mpox crisis snowballing.

“People hide their symptoms because they are afraid of being shunned. This only helps the virus spread,” he warns.

Vaccines and vigilance

In Zambia’s Copperbelt Province, Vanessa Musonda cares for her infected husband while trying to protect their children.

“We sleep in separate rooms, but I am terrified my kids will get sick too,” she tells TRT Afrika. “There’s no vaccine here yet. We rely on prayers.”

Although vaccination campaigns are underway, with over 650,000 doses administered in six African countries (90% in the DRC), much more needs to be done – and fast.

Dr Jean Kaseya, a frontline healthcare worker in DRC’s Goma, describes the fight against mpox as more than combating a public health emergency.

"We are vaccinating as fast as we can, but stigma surrounding mpox in eastern DRC cuts off entire communities. People are scared, and some still believe mpox is a curse," he says.

On the positive side, laboratory capacity in DRC has expanded, with 23 testing sites now operational —up from just two in 2023.

Sustainability depends on how quickly the authorities close funding gaps threatening progress, as more than US $220 million is still needed to maintain the response.

Seeking safeguards

As the Africa CDC and WHO push forward with their updated strategy against mpox, families like Monique’s await a future where the disease no longer threatens their children’s health.

After Joshua’s battle with mpox, Monique is particularly scared. Weeks in isolation and sustained treatment have helped the child recover, but the scars remain – both physical and emotional.

"No child should have to go through this," she says, cradling her son. "We need help now, and our leaders must act faster to bring more vaccines, more awareness.”