The Ministry of Health has announced three new cases of Mpox in Lilongwe, bringing the number of confirmed cases to 15 since Malawi reported the first in April.
Malawi is one of 16 African countries reporting Mpox outbreaks as health officials battle with vaccine shortages as well as limited testing and hospital capacity.
“The patients were aged between 17 and 41,” the Public Health Institute said recently. “Investigations are underway to establish the possible source of infection and trace contacts.”
The country’s first cases come after US aid cuts to healthcare, including HIV programmes, raised fears of escalated infectious diseases. The US government was pumping more than $350m to Malawi annually, according to the US Department of State.
In March this year, UNAids, the Joint UN Programme on HIV and Aids, drew attention to the immediate risks of the US funding cuts on HIV programmes in the country and healthcare authorities say drug shortages have forced some patients to stop taking HIV medication.
“A commonality about these cases is that some were immunocompromised,” said Lilongwe District Health Office spokesperson Richard Mvula.
The virus that causes Aids can worsen the risk and severity of Mpox, while effective HIV treatment can help manage the risk.
Malawi had been on alert since 2022 when the global mpox outbreak began in 2022 in the Democratic Republic of the Congo.
While most cases have been restricted to the capital city, a two-year-old was found with the condition in Mangochi District, about 240 kilometres away.
While recorded cases remain low in the country, mpox has surged across southern Africa.
Africa Centers for Disease Control and Prevention (Africa CDC) reports 52 082 cases since January, with over 1770 deaths during the outbreak as a whole.
Last week, Africa CDC officials told journalists that they were seeing different patterns of transmission between countries and the continent would need about 6.4 million doses of vaccine, but had only 1.3 million so far.
They also highlighted a lack of testing capacity in many countries and warned that in Sierra Leone, where the virus was spreading “exponentialy”, patients were being treated two to a bed.
Malawi’s health system faces many challenges, including long distances to clinics, insufficient funding, a shortage of equipment and a lack of qualified personnel.
Knowledge of mpox around the country is low, reminiscent of the Covid-19 outbreak where myths were rife and people resorted to tree leaves and herbs to cure the symptoms. Thousands of people died.
A series of interviews across the capital showed most people have no knowledge of mpox.
Taxi driver Steven Banda shared what he knew: “I came across a Ministry of Health official who advised that we should be careful since it is dangerous.
“She described the symptoms, including swellings and mentioned some of the districts affected. I’m not aware of any cases in my area or seen anyone suffering from the disease. We don’t know much about it.”
Society of Medical Doctors president Dr Victor Mithi said there is need for significant vigilance among practitioners within hospitals to ensure that “as we perform our day-to-day clinical procedures, we are able to screen those patients that may be having this condition”.
He said: “It is a big concern because in Malawi, most people live in crowded houses and still believe that as a form of expression of love, you need to shake hands, you need to hug people and all those things which are basically the risk factors in the transmission of this disease.”
Mithi said that with the lessons from Covid-19 and other infectious diseases, Malawi had the capacity to manage mpox, at clinical and community level.
“The challenge exists though because of the withdrawal of the US aid,” he said. “The capacity of our healthcare system is no longer the same.”
According to the doctor, donors contribute almost 60 percent of the Malawi’s healthcare spending—and over half of the donor aid was coming from the US.
“Our healthcare system is completely shaken,” says Mithi. “We are left in a state where we didn’t build internal capacities to sustain ourselves.” —The Guardian
