How to prevent corruption in Africa’s mpox response: Lessons from past health crises
A health worker collects a sample at a mpox treatment centre in the Democratic Republic of Congo. The UN is concerned about the rise in cases and spread to neighbouring countries. Photo: Guerchom Ndebo/AFP
On 14 August, the World Health Organization declared the mpox outbreak a “public health emergency of international concern.” This classification, previously used for crises like Ebola and COVID-19, means the outbreak requires a coordinated international response. The Democratic Republic of Congo accounts for 90 per cent of reported cases in 2024. So far, 15 other African countries, including Burundi, Kenya, Rwanda and Uganda, have also reported cases. However, due to limited testing and surveillance capabilities, the true scale of the outbreak remains unclear.
While comparisons to COVID-19 might arise, experts stress that mpox is different. It spreads through close physical contact rather than airborne transmission and doesn’t mutate as rapidly. Authorities already know how to control its spread, and with the right measures, it can be contained. But Africa faces unique challenges that complicate its ability to respond, including vaccine shortages, low public awareness and vulnerability due to HIV and malnutrition. Additionally, systemic corruption in many countries often results in critical funds being siphoned away from healthcare.
Africa can prevent corruption in its mpox response by learning from past health crises like COVID-19 and focusing on transparency, oversight and accountability. Photo: Prasesh Shiwakoti/Unsplash
The emergency declaration signals that the time to act is now. The international community must provide support, resources and funding to help manage the outbreak. Improving access to testing, vaccines and treatments must be a priority. However, Africa continues to face longstanding issues of global vaccine inequity, where the continent receives only a fraction of the needed doses. The Africa Centres for Disease Control and Prevention reports a need for approximately 10 million vaccines, yet only three per cent are currently available. Meanwhile, wealthier countries are stockpiling vaccines, leaving African countries struggling to protect their populations.
The mpox outbreak offers us an opportunity to avoid past mistakes. During the COVID-19 pandemic, corruption risks such as nepotism, favouritism, embezzlement, conflicts of interest, undue influence and bribery arose when the process of vaccine distribution wasn’t held to account. For example, Rwanda’s COVID-19 vaccination rollout reportedly faced criticism for secrecy and lack of procurement. In Kenya, Canada, Peru and Poland, reports emerged of wealthy individuals cutting the line to receive vaccine ahead of their designated turn.
Such corruption risks can lead to lower immunisation rates, delays in vaccination and reduced use of public health clinics, hindering efforts to control the outbreak. To prevent these issues in the mpox response, transparency and accountability must be at the forefront of all actions.
Mpox also poses unique risks to already marginalised groups, including women, sex workers and the LGBTQ+ community. Due to the virus’s transmission through intimate contact, sex workers are disproportionately affected. Women, in turn, are more vulnerable to corruption and sextortion in healthcare systems. The LGBTQ+ community often confronts additional layers of discrimination, stigma and isolation. To avoid repeating past mistakes, addressing discriminatory corruption – where discrimination exacerbates corrupt behaviour – is essential to creating an inclusive and effective response.
Double harm when corruption meets discrimination
Corruption and discrimination are both recognised as significant barriers to achieving an equal and inclusive future. Both have so far been considered separately. This study by Transparency International and the Equal Rights investigated corruption and discrimination interact, we listened to the experiences of corruption among people facing discrimination and uncovered some disturbing patterns
Lessons from past health emergencies give us hope because we’ve learned how to make vaccine distribution more transparent and accountable. This includes:
- Independent oversight: Establishing oversight bodies with auditing power can help ensure fair distribution.
- Transparency in procurement: Making procurement contracts publicly accessible helps prevent corrupt practices.
- Community involvement: Engaging communities in monitoring efforts can promote accountability and trust.
- Whistleblower protections: Safeguarding those who report wrongdoing encourages the exposure of corrupt activities.
Also, investing in long-term healthcare infrastructure is crucial for preventing and handling future outbreaks. These steps can create a fairer process, boost public trust and improve health outcomes.
Controlling the mpox outbreak is within our reach, but only if we commit to learning from past health crises. By increasing accountability, strengthening governance and tackling corruption, we can build a more resilient, transparent, and equitable global health system that truly leaves no one behind.
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