Assessing mpox epidemic readiness status in ECOWAS region: strengths, gaps, and recommendations for an improved response.

Mpox (formerly known as monkeypox) has re-emerged as a significant public health threat in West Africa, creating new challenges for regional and national health systems. Drawing from past outbreaks, the West African Health Organization (WAHO) has been proactive in enhancing public health preparedness, aligned with WHO recommendations. This study aims to assess the readiness of the ECOWAS region to manage the ongoing mpox outbreak, focusing on critical areas of national epidemic preparedness and response. A survey using the WHO mpox-epidemic readiness checklist tool was conducted in 14 ECOWAS Member States from August 25 to September 15, 2024. Key stakeholders, including Directors of Public Health and Heads of National Public Health Institutes, participated in the assessment. Mpox preparedness meetings and training reports from WAHO were also reviewed to evaluate the region's efforts. A thematic analysis identified key themes, strengths, challenges, and gaps in mpox readiness. The findings revealed considerable variations in readiness across ECOWAS countries. Strengths include established coordination structures, operational surveillance systems, and developed risk communication plans. However, there are major gaps in laboratory capacity, case management, and logistics. Countries such as Liberia and Guinea-Bissau lack sufficient healthcare workers and ICU facilities for managing severe mpox cases. In Senegal and The Gambia, inadequate adaptation and translation of Information, Education, and Communication (IEC) materials hamper public awareness. Logistic challenges, particularly the absence of emergency supply mechanisms and cold chain capacity, also hinder effective responses. Despite progress in mpox preparedness, ECOWAS countries must address significant gaps in laboratory capacity, healthcare infrastructure, and logistics through enhanced coordination and investments.