As Mpox persists across Africa, a surprising strategy emerges from the shadows of the COVID-19 pandemic. Home-based care, once a necessity during overwhelmed hospitals, is now a key weapon in the fight against this ongoing outbreak. But here's where it gets controversial: while it eases the burden on healthcare facilities, experts warn it could become a double-edged sword without strict oversight.
Professor Yap Boum, leading the Mpox response in the DRC, explains: “We learned from COVID-19 that hospital isolation isn’t always feasible. In Uganda, for instance, overwhelmed treatment centers forced us to isolate patients at home, with dedicated rooms and community health worker follow-ups for 21 days.”
This approach, however, is only suitable for mild cases. Its success hinges on rigorous infection prevention and control (IPC) measures within households. This requires clear guidelines, strong community involvement, and constant monitoring to prevent further spread.
And this is the part most people miss: countries are navigating this delicate balance differently. Sierra Leone initially relied heavily on home-based care but shifted to establishing treatment centers as cases surged. Liberia and Zambia manage 80% of cases at home, while Burundi opts for hospital admission for all.
Dr. Patrick Kabwe of the Africa CDC stresses the need for comprehensive support: “Home-based care isn’t just about isolation. It requires nutrition packages, trained community health workers, and IPC kits with essentials like soap and medical supplies.”
Efforts are underway to strengthen this approach through updated guidelines, incorporating risk communication, community engagement, and improved surveillance. Dr. Ngashi Ngongo emphasizes, “While not all cases need hospital care, institutional support remains crucial in certain situations.”
Preventive measures like fractional vaccination, where doses are divided among individuals, are also being deployed to stretch limited vaccine supplies. Yet, access to vaccines remains a critical challenge, with storage and distribution adding further complexities.
To date, over one million people across 12 countries have been vaccinated, but Professor Boum highlights the gap: “We need 6.4 million doses to contain the outbreak, but only five million have been secured. Vaccines aren’t a cure-all, but they’re vital in areas with limited contact tracing and health infrastructure.”
The Africa CDC declared the outbreak a continental health emergency in August 2024, with WHO Africa extending its emergency response for six more months. The joint Incident Management Support Team (IMST) marks a turning point, showcasing African-led coordination with global support. This model, now guiding the cholera response in 23 countries, signals a shift towards integrated public health management.
But is home-based care the sustainable solution Africa needs? While it offers practicality in resource-constrained settings, its success relies on robust community engagement, consistent monitoring, and equitable access to vaccines. What do you think? Is this approach a viable long-term strategy, or does it risk exacerbating the outbreak? Share your thoughts in the comments below.
