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Diplomania
Oct 205 min read

The Impact of the Monkeypox Endemic on Nigeria, Ghana, and the Congo

By: Anant Kakkar


The author is a second-year bachelor’s student at Jindal School of International Affairs. He can be reached at



The Monkeypox crisis (‘Mpox’) presents a significant threat to public health and its requisite infrastructure in Western and Central Africa, particularly in the Democratic Republic of Congo (DRC), Ghana, and Nigeria. The rapid propagation of Mpox in fragile political systems, compounded by their historical instability, has raised concerns in the international community about the potential impact of the disease on the political and social stability in the region. 

This article will draw parallels between these government’s responses to the current Mpox endemic and that of their response to the COVID-19 pandemic. It will thus highlight how a public health crisis can impact governance, political stability, public trust, and the influence of non-state actors such as terrorist outfits and insurgent groups in this region. 


Historically speaking, outbreaks of disease have exacerbated political instability, which already is a persistent issue in many African states. For example, in the case of Nigeria, where the healthcare system has limited capacity to handle large outbreaks, the COVID-19 pandemic brought into focus the failings of the government to adequately fund the country’s burgeoning health sector.  


In the case of DRC, Nigeria and Ghana, public health crises have often brought into view the existing institutional weaknesses and worsened the societal divide. This has been the result of the spread of misinformation, ineffective communication strategies and delayed responses from the government at managing the crisis at hand. This inaction and mismanagement by the governments has resulted in plummeting public trust, anti-government protests, and civil unrest. 


The Mpox crisis, much like COVID-19, has disproportionately impacted countries with weaker healthcare and pandemic response infrastructure. According to recent reports, the DRC has seen significant outbreaks of Mpox, with 6,000 lab-tested and confirmed cases and approximately 29,000 unconfirmed cases as of mid-2024 (2022-2024). Nigeria has faced several outbreaks in the nation, with approximately 900 lab-tested and confirmed cases. Ghana has over 100 lab-tested and confirmed cases in total. While these numbers may seem insignificant in comparison to the COVID-19 numbers, the rapid spread of the disease combined with a myriad of unassuming symptoms such as a rash, fever, sore throat, headache, muscle ache, back pain, etc., can result in a similar escalation if not properly dealt with and contained. 


The reaction of the governments in the DRC, Nigeria, and Ghana to the Mpox crisis reflects their response to the COVID-19 pandemic. The DRC government’s response was limited to containing the pre-2020 Mpox cases, as it was simultaneously dealing with an Ebola outbreak at the time. The outbreak had become a global health emergency by May of 2022; the government responded to the situation as late as August with awareness campaigns and increased surveillance. This mirrors its delayed handling of the COVID-19 pandemic, with its outbreak beginning on the 10th of March in 2019. The government took 2 weeks to even implement a partial lockdown, which was lifted early due to economic issues in May of 2020.  This has been especially compounded in provinces like North and South Kivu due to preexisting political instability and conflict, such as the heavy M23 rebel presence, as well as the Mai-Mai militias and the Democratic Forces for the Liberation of Rwanda rebel group. These groups control significant amounts of territory and engage in activities such as illegal mining and human trafficking to finance their activities. The DRC’s government faces an even greater challenge with its lack of diagnostic capability as well as its insufficient and limited sequencing of Mpox clades, which suggests that the spread of Mpox could be significantly more widespread than last reported. 


Nigeria has fared quite well as it has incorporated the lessons it learnt from the COVID-19 pandemic. The government in Nigeria has sufficiently strengthened its surveillance and containment measures such as lockdowns for the Mpox endemic and has thus shown a more proactive stance in contrast to its actions and measures during the COVID-19. However, despite these improvements, the key issues of vaccine access, diagnosis capabilities and cold storage facilities for the vaccines remain woefully inadequate in rural, remote, and urban slum areas such as in the Kano and Delta states, considering the level of the crisis Nigeria is facing. 


Ghana attempted to use a more coordinated and structured approach to the Mpox crisis after having managed both Ebola and COVID-19 by implementing better inter-agency coordination as well as the establishment of an interagency task force consisting of the Ministry of Health, the Ghana Health Service, and the National Disaster Management Organization. An improved surveillance system and diagnostics response teams was implemented during the Ebola and COVID-19 outbreaks in the country. However, good coordination has its limits, as inadequate healthcare infrastructure and the fact that public communication was delayed by 3 weeks continued to hamper the effective containment of the Mpox outbreaks. 


With regards to the political stability in the DRC, Mpox has already exacerbated a previously precarious political situation with armed groups such as the M23, the Allied Democratic Forces (ADF) and various other local militia groups controlling substantial portions of the provinces of North Kivu, South Kivu, and Ituri. This has, in turn, caused internal displacement and a refugee crisis, along with continuous elections and accusations of corruption and financial mismanagement. Clashes between various armed groups, such as the ADF and the government, have increased exponentially as these groups try to take advantage of the chaos caused by the Mpox endemic. The reduced military presence because of focus on the outbreak hotspots, has resulted in these rebel groups seizing medical supplies, blocking access to healthcare as well as filling the void where the government cannot provide basic services by stepping in as an alternative authority and thus expanding their territory. The government is thus struggling to maintain control in these conflict zones. The endemic, combined with ongoing violence, has eroded the public’s trust in the government’s ability to manage the public health crisis as well as maintain peace and order simultaneously.  

 

While Nigeria has fewer cases as compared to the DRC, Mpox has nevertheless put intense pressure on the political system of Nigeria. In the northeast, where Boko Haram remains active, Mpox has created a vacuum in healthcare provision and infrastructure and thus has made it harder for the government to project authority and enforce law and order. The lack of vaccines has also led to increased public frustration. There is now a rising concern that another wave of instability will emerge if the government fails to address the crisis at hand. 

Ghana’s stable political environment has assisted in mitigating some of the worst impacts of the Mpox endemic. However, the inability of the healthcare system to address both the new Mpox crisis as well as other existing health issues such as Malaria, HIV/AIDS and Tuberculosis outbreaks threatens to overturn this balancing act. If this situation of an overburdened healthcare system continues to worsen and the existing economic conditions continue to deteriorate, the criminal elements in Ghana could emerge as major players by exploiting public outrage at the government. 


The Mpox crisis currently poses a serious and grim threat to the political and social stability of the DRC, Nigeria, and Ghana. By extrapolating and analysing the details from the COVID-19 pandemic, it is self-evident that the impact the health crises have on political stability is profound. If these governments fail to build on the lessons learned from previous pandemics and endemics such as COVID-19, the influence of non-state actors could end up destabilizing the region and could escalate into a broader political crisis, with disturbing implications for regional stability in West and Central Africa.  


References


Bibliography  World Health Organization. "Mpox." World Health Organization, 10 Aug. 2023, https://www.who.int/news-room/fact-sheets/detail/mpox. 

World Health Organization. "Monkeypox Outbreak 2022." World Health Organization, https://www.who.int/emergencies/situations/monkeypox-oubreak-2022. 

World Health Organization. Mpox Global Dashboard. https://worldhealthorg.shinyapps.io/mpx_global/. 

World Health Organization. Mpox: Vaccination and Protection Guidance. World Health Organization, 2024, https://iris.who.int/bitstream/handle/10665/371663/9789240077287-eng.pdf?sequence=1. 



The views expressed in this article are those of the author (s). They do not reflect the views or opinions of Diplomania or its members.

 

   

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