Africa is facing a significant and ongoing mpox crisis, with more than 61,383 confirmed cases and 296 deaths reported across 32 countries since early 2024. This stark data, released by the Africa Centres for Disease Control and Prevention (Africa CDC), underscores the urgent need for effective treatments on a continent disproportionately affected by the disease. The announcement coincides with a major push to advance a landmark, Africa-led clinical trial that could finally deliver dedicated antiviral therapies.
The heart of this effort is the MpOx Study in Africa (MOSA), a double-blind, platform-adaptive clinical trial launched in 2024. Unlike traditional trials that test a single drug, a platform trial is designed to efficiently evaluate multiple potential treatments simultaneously, allowing researchers to adapt quickly based on interim results. This innovative approach is crucial for responding to dynamic outbreaks. The trial recently passed a critical safety milestone when an independent Data and Safety Monitoring Board (DSMB) reviewed data from the first 50 patients and recommended its continuation, finding no safety concerns.
“This study represents a critical step in generating evidence to inform mpox treatment and strengthen Africa’s capacity to respond to emerging health threats,” said Dr. Jean Kaseya, Director General of Africa CDC. He emphasized that the initiative is about more than just one disease; it’s about building sustainable research infrastructure and preparedness for future outbreaks.
The research momentum has gained further support through a new collaboration between Emergent BioSolutions and the Pandemic Preparedness Platform for Health and Emerging Infections Response (PANTHER), which will provide additional financial backing for MOSA. “We applaud Africa CDC, the Democratic Republic of the Congo (DRC) investigators and PANTHER for their efforts,” said Dr. Simon Lowry, Chief Medical Officer at Emergent BioSolutions, highlighting the partnership model essential for tackling global health threats.
Why This Trial is So Critical: The Treatment Gap
The MOSA trial addresses a glaring gap in global health. Currently, there is no antiviral therapy specifically approved for mpox. Patients, particularly those with severe disease, are often treated with supportive care or repurposed smallpox drugs like tecovirimat, which have limited clinical data for mpox. This trial aims to generate the robust, continent-specific evidence needed to change that paradigm and save lives.
The Complex Landscape of Mpox in Africa
The challenge is compounded by the presence of multiple mpox clades (genetic groups) in Africa, each with different characteristics. As noted by Africa CDC:
- Clade I: Endemic to Central Africa (especially the DRC) and associated with more severe illness and higher mortality. Recent outbreaks have involved subclades Ia and Ib.
- Clade II: More prevalent in West Africa and generally causes less severe disease. The 2022-2023 global outbreak was driven by Clade IIb.
This virological diversity means that treatments must be effective across different strains, making research conducted on the African continent, where both major clades circulate, indispensable.
The MOSA trial is initially focused in the Democratic Republic of the Congo, a country with a long history of Clade I outbreaks and a high burden of cases. Plans are underway to expand the trial to other nations, including Uganda, to ensure the findings are representative and applicable across diverse African populations and healthcare settings.
Health experts point out that the true significance of MOSA extends beyond mpox. It is a powerful demonstration of Africa-led clinical research, shifting the paradigm from being a site for data collection to being the architect of solutions. By building local capacity for complex trial design and execution, Africa is not only seeking to control the current mpox epidemic but is also fundamentally strengthening its pandemic preparedness for the future.
Edited by Kevin Okunzuwa
Source: News Agency of Nigeria (NAN)
