MPOX outbreak in Africa: the urgent need for local manufacturing of the vaccine and decolonized health systems

Abstract

BACKGROUND: The resurgence of MPOX (formerly known as Monkeypox) across African countries has highlighted longstanding deficiencies in epidemic preparedness, vaccine access, and healthcare infrastructure on the continent. Despite bearing a significant disease burden, African nations continue to face delays in vaccine acquisition and distribution, reflecting more profound structural and historical inequities. METHODS: This systematic review synthesizes literature published between 2016 and 2024, including peer-reviewed articles, policy documents, and institutional reports. The review aims to explore the dynamics of MPOX outbreaks in Africa, patterns of vaccine inequity, and the systemic limitations that hinder local response capacity. A narrative synthesis approach was employed to analyze data relating to vaccine access, production capacity, regulatory environments, and structural determinants of health. RESULTS: The findings reveal Africa's continued dependency on external vaccine sources, shaped by colonial legacies and weak local pharmaceutical systems. During the 2022 global MPOX outbreak, high-income countries swiftly secured vaccine supplies, while African nations experienced significant delays despite high transmission rates. Although efforts to establish local manufacturing are emerging, they are constrained by limited infrastructure, fragmented regulatory systems, shortages of skilled workers, and restrictive intellectual property regimes. Furthermore, the review identifies a need for harmonized regulatory frameworks and sustainable investment in regional manufacturing capabilities. CONCLUSION: Addressing MPOX and future health threats in Africa demands a shift toward decolonized health systems that emphasize South-South collaboration, indigenous knowledge, and local ownership. Strategic interventions, such as regulatory harmonization, equitable technology transfer, and capacity-building, are essential to reduce external dependency. Coordinated short-term actions and long-term investments are crucial for fostering resilient, self-sustaining health systems that can respond effectively to emerging infectious diseases.