The Africa Centres for Disease Control and Prevention (Africa CDC) has raised alarm over changing patterns of infectious disease outbreaks across the continent, warning that transmission hotspots are no longer static.
The agency said diseases such as Mpox and cholera are increasingly moving across national boundaries, driven by population movement and gaps in cross-border surveillance.
Dr Wazih N. Cho, Intelligence and Data Analyst at Africa CDC’s Division of Surveillance and Disease Intelligence, made this known during the agency’s weekly outbreak briefing on Thursday.
According to him, recent surveillance findings show that infections are no longer contained within individual countries but are spreading across regions due to human mobility and weak monitoring systems at borders. He noted that about 85 per cent of confirmed Mpox cases in Africa are currently concentrated in a few member states, including Madagascar, Guinea, Kenya and Liberia, with Madagascar remaining the most severely affected because of sustained human-to-human transmission. He added that Guinea, Kenya and Liberia continue to record relatively low case numbers, mostly in single or double digits, while Madagascar remains the primary hotspot with ongoing transmission and potential risk of spread to neighbouring countries.
“The transmission is increasingly being driven by a few member states, but what is more concerning is the cross-border movement of cases, especially from high-burden areas,” he said.
He also revealed that recent alerts confirmed Mpox cases in Mauritius linked to travel, stressing the importance of stronger regional surveillance, faster detection and coordinated response mechanisms. The two confirmed cases in Mauritius, he said, were quickly isolated, with contact tracing and risk communication activated alongside support from national authorities and Africa CDC response teams.
On cholera, Cho said Africa has recorded a general decline in cases compared to previous years, but cautioned that the fatality rate remains above the global benchmark of one per cent, currently estimated at about 2.2 per cent. He identified the Democratic Republic of Congo (DRC) and Mozambique as the leading contributors to cases and deaths, accounting for about 59 per cent and 21 per cent respectively, with the DRC responsible for most fatalities. He also expressed concern about new outbreaks emerging in countries such as Angola, Burundi and the Republic of Congo.
He attributed the continued spread to poor water supply, inadequate sanitation and environmental disruptions. Using Angola as an example, he highlighted how structural weaknesses are sustaining outbreaks despite ongoing interventions:
“In Angola, about 44 per cent of the population lacks access to safe drinking water and 55 per cent lacks adequate sanitation.
“In some areas, we are seeing outbreaks shift to new locations even after interventions.
“This tells us that without addressing underlying issues such as water and sanitation, we will continue to run behind the disease,” he said.
Cho added that Africa CDC is scaling up cross-border surveillance, vaccination campaigns and emergency coordination efforts among member states to curb further spread. He disclosed that more than five million doses of Mpox vaccines have already been distributed to 19 countries, with ongoing vaccination activities in at least 15 member states.
While noting progress in reducing overall infections, he warned that persistent hotspots such as Madagascar and emerging clusters in other countries underscore the urgent need for stronger regional cooperation. He further urged member states to invest in sustainable public health systems, especially in water, sanitation and disease surveillance, to reduce the risk of future outbreaks.
