MPox strains Sierra Leone's fragile health system

Physicians from Médecins sans Frontières (MSF or Doctors Without Borders) have recently reported that Sierra Leone is experiencing an outbreak of monkeypox, or MPox, with an average of 120 new cases recorded daily since April 25, 2025. 

MSF has rehabilitated an infectious isolation ward in the nation's capital to support the response to the outbreak.

They have also donated infection prevention and control materials and installed a chlorine production unit.

Furthermore, MSF donated a pickup truck and four motorbikes to the district health management team in Kenema District, located in eastern Sierra Leone, to enhance surveillance and contact tracing for MPox and Lassa Fever.

With a population of 8.3 million, Sierra Leone's health system had already been struggling, as highlighted by the Ebola virus epidemic. 

A 2022 study revealed that all vaccine doses came from abroad. 

On April 23, 2025, Saidu Bah reported that Sierra Leone became the 14th member state of the African Union to deploy the MPox vaccine, receiving 61,300 doses from Gavi and the Republic of Ireland.

The Africa Centers for Disease Control and Prevention (Africa CDC), the World Health Organization (WHO), and UNICEF provided technical assistance for the vaccine rollout.

The vaccination campaign began in late March 2025, prioritizing health workers and individuals who had contact with MPox patients. 

Bah noted that the 26-bed MPox ward at the 34 Military Hospital, an infectious disease facility on Freetown's Wilberforce Military Base known for effectively handling epidemics such as Ebola, COVID-19, and Lassa Fever, has been operating at full capacity.

As the epidemic continues to grow and the number of beds in the MPox ward is limited, many patients have been referred to newly established treatment centers.

Health workers, security officers, contacts, and relatives of MPox patients are prioritized for immunization during the campaign. Health Minister Austin Demby emphasized this focus during the vaccination drive's launch.

Sierra Leone's Minister of Health, Dr. Austin Demby, recently stated that the National Public Health Agency is conducting a nationwide operation to contain the spread of the virus and effectively target the vaccination roll-out.

Vaccines are recommended for individuals aged 12 and older and will be distributed in areas identified as disease hotspots.

Speaking to the country's Parliament, Dr. Demby attributed the recent surge in MPox cases to non-compliance with healthcare directives from professionals.

He emphasized the urgent need to address the outbreak, which he stated worsens daily due to the community's failure to follow these health guidelines.

He urged that individuals infected with MPox should be transferred to appropriate healthcare facilities for comprehensive treatment.

Sierra Leone has approximately 63,000 MPox vaccines, and the health ministry plans to develop new healthcare regulations for all citizens.

The minister reported that the outbreak began in January 2025 with two cases, but by May 2025, more than 2,000 cases had been reported.

Dr. Demby explained that MPox is a virus transmitted through direct body contact. He mentioned that vaccination is also essential to curb the outbreak's spread.

Mpox Timeline in Sierra Leone

• An emerging disease research letter published in May 2019 by the Centers for Disease Control and Prevention (CDC) in Atlanta, Georgia, noted the reemergence of human monkeypox in Sierra Leone after a 44-year absence.
• The CDC indicated that this resurgence warranted renewed vigilance and awareness regarding the disease and its symptoms.
• Before the year 2000, only 21 cases of monkeypox had been documented in the region, including a single case in Sierra Leone in 1970, after which the disease had not been observed in the country.
• A 2007 survey near Kenema, Sierra Leone, provided evidence indicating ongoing circulation of Orthopoxviruses in the area.
• Physicians from Médecins sans Frontières (MSF) working in a pediatric ward suspected a child might have monkeypox and alerted national authorities. Following consultation with the Directorate of Disease Prevention and Control of the Sierra Leone Ministry of Health and Sanitation, Kenema scientists contacted the CDC.
• On March 25, 2017, a 35-year-old male farmer from Pujehun district presented at Pujehun Government Hospital with symptoms including fever, generalized body aches, enlarged cervical lymph nodes, difficulty swallowing, malaise, and a rash with papules and macules.
• Samples were collected and sent for laboratory analysis, confirming the presence of monkeypox. Community sensitization efforts were then initiated.
• In December 2024, the Nonprofit Quarterly reported that local and international health agencies have been working to contain the outbreak, with vaccination campaigns and public awareness efforts targeting high-risk groups. 
• MPox was declared a public health emergency in January 2025.