GOMA, Congo (AP) — Some health officials say mpox cases in Congo appear to be ‘stabilizing’ – a possible sign that the main outbreak for which the World Health Organization has established an assessment global emergency declaration in August could be down.

In recent weeks, Congo has reported about 200 to 300 laboratory-confirmed cases of mpox each week, according to the WHO. That’s down from nearly 400 cases per week in July. The decline is also visible in Kamitugathe mining town in eastern Congo where the new, more contagious variant of mpox first appeared.

But the U.N. health agency acknowledged Friday that only 40% to 50% of suspected infections in Congo are being tested — and the virus continues to spread in parts of the country and elsewhere, including Uganda.

Although doctors are encouraged by the decline in infections in some parts of Congo, it is still unclear exactly what types of physical contact are causing the outbreak. Health experts are also frustrated by the low number of vaccine doses the central African country has received – 265,000 – and say it is proving difficult to deliver the vaccine where it is needed in the sprawling country. . The WHO estimates that 50,000 people have been vaccinated in Congo, which has a population of 110 million.

Scientists also say urgent action is needed, a broader vaccination effort for the entire continent to stop the spread of mpox and prevent further worrying genetic mutationslike the one detected earlier this year in Congo after months of low circulation.

“If we miss this opportunity, the likelihood of another significant outbreak increases significantly,” said Dr Zakary Rhissa, who leads operations in Congo for the charity Alima.

So far this year, there have been around 43,000 suspected cases in Africa and more than 1,000 people diedmainly in Congo.

“We have seen how past outbreaks, like Nigeria’s in 2017, can lead to larger global events if not effectively contained,” he said. The 2017 epidemic eventually led to that of 2022 global mpox epidemic which affected more than 100 countries.

Rhissa said the drop in cases in Kamituga – where mpox initially spread among sex workers and minors – is an opening to implement more vaccination, surveillance and education programs.

Georgette Hamuli, an 18-year-old sex worker, was unaware of mpox until vaccination teams arrived last week in the poor neighborhood where she works in Goma, the largest city in eastern Congo. Congo.

“They told us we were at high risk of infection,” she said. “We insist on condoms to our customers, but some refuse… if they don’t want to use condoms, they double the amount they pay.”

Hamuli said she and other sex worker friends each received 2,000 Congolese francs ($0.70) from a charity to get the mpox vaccine – but it’s not the money that influenced her.

“The vaccine is also necessary,” she said. “I think we are now protected.”

The Africa Centers for Disease Control and Prevention has estimated that Congo needs at least 3 million mpox vaccines to stop the virus, and another 7 million for the rest of Africa. So far, WHO and partners have allocated 900,000 vaccines to nine mpox-affected African countries and expect 6 million vaccines to be available by the end of this year.

Viral smallpox outbreaks in Burundi, Kenya, Rwanda and Uganda originated in Congo, and a number of cases in travelers have also been identified in Sweden, Thailand, Germany, India and Great Britain. Brittany.

Less than half of those most at risk in Congo have been vaccinated, according to Heather Kerr, Congolese director of the International Rescue Committee.

“We only have a tiny amount of vaccines and nothing for children,” she said.

Vaccines for Congo come largely from donor countries like the United States and UNICEF, which mainly uses taxpayer money to buy the vaccines.

“We benefit from a charitable approach where we see very small donations of vaccines to Africa,” said Dr. Chris Beyrer, director of the Global Health Institute at Duke University. “What we need is a public health approach where we immunize populations at scale. »

Pharmaceutical manufacturer Bavarian Nordic, which makes the most widely used mpox vaccine, said it would sell vaccines for Africa at the lowest possible price.

The advocacy group Public Citizen estimated that UNICEF paid $65 per dose of the Jynneos mpox vaccine made by Bavarian Nordic, a much higher amount than almost all other vaccines used in public health programs.

Dr. Salim Abdool Karim, an infectious disease expert at the University of KwaZulu-Natal in South Africa, said mpox outbreaks usually peak and disappear quickly because of the way the virus spreads. This time, however, he said there are two factors complicating the situation: sexual transmission of the virus and the continued spread of infected animals.

“This time we are in uncharted territory with mpox,” he added. “But we will never solve this problem until we vaccinate most of our population.”

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Cheng reported from London.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. The AP is solely responsible for all content.