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It's been six months since mpox was declared an international health emergency. But it still continues to impact a dozen African countries with about 900 new cases confirmed per week. Now experts say the outbreak stands at a critical moment as the halt on U.S. foreign assistance, along with rebel violence, scramble efforts to control the spread of the virus. NPR's Gabrielle Emanuel reports.
GABRIELLE EMANUEL, BYLINE: Goma is a city that's known hard times. It's in the eastern part of the Democratic Republic of Congo, a region plagued by conflict and violence. The city is surrounded by overcrowded camps for displaced families and mining towns with transient workers. This is where mpox infections were really taking off. It's a highly contagious disease that causes painful blisters and can be deadly. So governments from across Africa to Japan, France and the U.S. came together to help the DRC get the outbreak under control and keep it from spreading to other parts of the world. Paulin Nkwosseu works for UNICEF in Goma. All that effort, he says, it was starting to make a difference.
PAULIN NKWOSSEU: We were just managing, and I think the outbreak was even going a little bit down.
EMANUEL: One big piece of the response is a vaccination campaign. The U.S. had pledged a million doses of the mpox vaccine and $500 million for the containment effort across the region for things like training health workers, diagnostic tests, gloves and gowns for staff working in dedicated treatment centers.
NKWOSSEU: We have around 140 mpox patient who were in isolation in the mpox treatment center around Goma.
EMANUEL: Then late last month...
NKWOSSEU: From one day to another, everything has just collapsed.
EMANUEL: One of the rebel groups took over Goma, and when they did, the mpox treatment centers were looted, and more than a hundred patients fled for their safety.
NKWOSSEU: After the fighting erupted, we managed to locate only 15. So the rest is probably living within the community with a huge, huge risk of contamination.
EMANUEL: Contamination, meaning the virus spreads. Mike Ryan is with the World Health Organization.
MIKE RYAN: All of the investment we've made over the last number of months to establish mpox surveillance, mpox control, mpox vaccination, all of that is interrupted, on hold and impossible to continue.
EMANUEL: On top of that, President Trump froze almost all U.S. foreign assistance, including work done by the United States Agency for International Development. USAID had been playing a key role in mpox control efforts. I spoke with two people who worked on the mpox campaign. They requested anonymity for fear of retribution. They said after the funding freeze, U.S. involvement in the outbreak ground to a halt, and hundreds of thousands of mpox vaccine doses are now stuck in a warehouse far from the DRC. One source compared the unraveling of the U.S. mpox effort to watching a train wreck in real time. The White House did not respond to requests for comment.
ANNE RIMOIN: It's a critical moment, for certain.
EMANUEL: Anne Rimoin is at the University of California, Los Angeles, and has worked on mpox in the DRC for 20 years.
RIMOIN: DRC has a very fragile health system, and USAID is an integral part of this fabric that is already stretched very, very thin.
EMANUEL: And she says without U.S. support, there will be disastrous setbacks for health in the DRC. And because diseases don't respect borders, she worries those setbacks could be felt elsewhere in the world, too.
Gabrielle Emanuel, NPR News. Transcript provided by NPR, Copyright NPR.
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