Limited response
The response to mpox has been hampered by a lack of resources.
The DRC does not have any rapid tests available to diagnose the clade one virus and there are only two laboratories nationwide for handling samples taken from suspected cases, meaning it can take up to three weeks to confirm test results.
There are also no vaccination campaigns. The smallpox jab has been given to vulnerable populations across the globe, mainly men who have sex with men, but the DRC currently only has access to the vaccine for research studies.
But even if the shot was more widely available, it is not yet clear what the vaccination strategy would be, or who would be targeted.
“It’s not something that’s going to happen overnight,” said Dr Lewis. “You can’t bring 100 million doses of vaccine and start vaccinating overnight.”
Accessing healthcare is also difficult for many. Where NGOs are working to provide free health services, they are generally overwhelmed, said the Kinshasa-based doctor.
But in places where visiting a doctor requires a fee, many of those affected can’t afford to get care. Elsewhere, the distances to reach a clinic may be prohibitive.
“A good proportion of cases are not seen in health facilities, that is why we can easily say that the 14,000 cases are an underestimate,” the doctor said.
“For many it is also difficult to go to the hospital when sick, so they look for traditional treatment or traditional medicine or have self medication instead… And we have no community based surveillance. So we are aware mpox is underreported.”
He added that response teams are going to communities to educate them about the symptoms to look out for, and how to practice good infection control. But in a vast country with more than 95 million people, this is a difficult task when resources are constrained.
“With the global outbreak, many things were done to respond,” the doctor said. “I think if we can use the same strength used to control the global outbreak, if the country can have the same type of response, we can easily control the outbreak in DRC and protect the whole world… but we need sufficient funding.”
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