[YAOUNDE] Nigeria is to begin the immediate rollout of 5,000 doses of mpox vaccines while the Democratic Republic of Congo (DRC) eyes its first shipment of 65,000 doses, as Africa steps up measures to control the multi-country outbreak.

The vaccine, administered in two doses, will go first to people at high-risk, including health workers and those living in areas with high infection rates, according to Nigeria’s National Primary Healthcare Development Agency.

Matshidiso Moeti, WHO regional director for Africa, said the delivery of 10,000 doses to Nigeria by USAID this week signified “a clear demonstration of international solidarity in the face of global public health emergencies”.

“The emergence of the new, more virulent variant (Clade Ib) and the increase in human-to-human transmission, with new routes such as sexual transmission, remains a cause for concern.”

Flaubert Mba, Centre for Research on Emerging and Re-Emerging Diseases

Nigeria became the first African country to receive the vaccine after confirming 40 cases of the disease, whose symptoms include fever, swollen lymph nodes and a rash leading to blisters.

The DRC, the country worst affected, is expecting to receive 65,000 doses of the vaccine on 1 September, announced Jean Kaseya, director-general of the African Centres for Disease Control and Prevention (Africa CDC), during an online press conference on Wednesday (28 August).

He said 50,000 doses would be sent by the US while 15,000 will be provided by Gavi, the Vaccine Alliance.

Kaseya said the JYNNEOS vaccine, made by Danish pharmaceutical company Bavarian Nordic, was one of the surest ways of stopping the mpox epidemic, alongside epidemiological surveillance and screening.

He stressed the vaccine was the same one used in the US and Europe to stem an outbreak of mpox – formerly known as monkeypox – in 2022.

“It has been given to millions of Americans and Europeans, which has made it possible to stop [that] epidemic,” he told the press conference.

In July, the emerging infectious diseases foundation CEPI announced trials in the DRC to see if vaccinating people already exposed to mpox stops them getting sick and spreading it.

Kaseya said Africa CDC would be sending 72 epidemiologists to affected areas in September to collect more data on case numbers, citing problems with the reliability of current data.

“These epidemiologists, in addition to the support they will be giving to the teams in the field, will also be focusing on the quality of the data, so that we can have data that will enable us to make good decisions,” he said.

“In the coming weeks, we will begin to provide what we believe to be quality data thanks to this support.”

Response plans

For the first time since its creation, Africa CDC declared on 13 August that the new mpox epidemic constituted a public health emergency of continental security (PHECS) in Africa. The next day, the WHO declared it a public health emergency of international concern (PHEIC).

Nicaise Ndembi, Kaseya’s scientific advisor and mpox response coordinator for the African Union and Africa CDC, told SciDev.Net: “This declaration marks an important moment in the history of public health in Africa and demonstrates the seriousness of the situation and the need for a unified, continent-wide response to this rapidly spreading disease.”

He stressed that it is now “urgent to take coordinated action at national, regional and international levels to stop the spread of mpox”.

Africa CDC is working to develop a “continental response plan”, which, according to Kaseya, should take into account the individual needs of each country. He said the plan will be presented to African heads of state for endorsement in the coming weeks.

The WHO has already launched a global strategic plan for mpox preparedness and response, which it says requires US$ 87.4 million over the next six months (September 2024-February 2025).

WHO director-general, Tedros Adhanom Ghebreyesus, speaking at the WHO Regional Committee for Africa in Brazzaville this week (26 August), stressed the need for more research and surveillance of the disease, as well as equitable access to vaccines.

“I am certain that with the leadership of the affected countries and the support of the WHO, partners such as CDC Africa and others, we will be able to bring this epidemic under control quickly, as we have been able to do with other epidemics in recent years,” he said.

New variants

According to the latest WHO epidemiological data, 14 African countries have reported cases of mpox so far, with Gabon confirming its first case of the virus on 22 August.

The DRC remains the country hardest hit by the epidemic, with a total of 3,244 cases and 25 deaths recorded to date this year.

Burundi has recorded 231 cases, while a number of cases have also been confirmed in Central African Republic (45); Côte d’Ivoire (28); South Africa (24), and Congo (23).

There are two main types of the virus, Clade I and Clade II. Clade I, endemic to Central Africa, causes more severe illness and disease. The less severe Clade II strain caused the global outbreak in 2022 and is the type being seen in Nigeria.

However, a novel, sexually transmitted strain of the virus, identified as Clade Ib, has started spreading across the DRC and neighbouring countries, causing alarm.

Flaubert Mba, wildlife specialist and One Heath focal point at the Centre for Research on Emerging and Re-emerging Diseases, told SciDev.Net: “The emergence of the new, more virulent variant (Clade Ib) and the increase in human-to-human transmission, with new routes such as sexual transmission, remains a cause for concern.”

In addition to vaccination and the recommended hygiene measures, he believes that African countries need to focus on epidemiological surveillance, particularly in areas where wildlife and people interact.

“Mpox is a re-emergent zoonosis, meaning that it is transmitted from animals to humans and vice versa,” he explained.

“Particular emphasis needs to be placed on at-risk areas associated with risk mapping and areas where there have been outbreaks in the past.”

This piece was produced by SciDev.Net’s Sub-Saharan Africa French desk and edited for brevity and clarity.

September 10, 2024 was World Suicide Prevention Day. According to the World Health Organization,

“Every year 726,000 people take their own life and there are many more people who make suicide attempts.”

When I was five years old my mid-life father took an overdose of sleeping pills after he had become increasingly depressed because he couldn’t support his family doing the work he loved. Fortunately, he survived, but our lives were never the same. I grew up wondering what happened to my father, when it would happen to me, and what I could do to prevent it happening to other families.

Although females, as well as males, can die by suicide, males at every age are at higher risk than are females. Yet rarely is suicide discussed as a health issue for boys and men.

World Suicide Prevention Day (WSPD) was established in 2003 by the International Association for Suicide Prevention in conjunction with the World Health Organization (WHO). On September 10^th each year they focus attention on the issues, reduce stigma and raise awareness among organizations, governments, and the public, giving a singular message that suicides are preventable.

The triennial theme for World Suicide Prevention Day for 2024-2026 is “Changing the Narrative on Suicide” with the call to action “Start the Conversation”. This theme aims to raise awareness about the importance of reducing stigma and encouraging open conversations to prevent suicides. Changing the narrative on suicide is about transforming how we perceive this complex issue and shifting from a culture of silence and stigma to one of openness, understanding, and support.

The call to action encourages everyone to start the conversation on suicide and suicide prevention. Every conversation, no matter how small, contributes to a supportive and understanding society. By initiating these vital conversations, we can break down barriers, raise awareness, and create better cultures of support.

I have been writing a series of articles—”Homecoming: An Evolutionary Approach for Healing Depression and Preventing Suicide.” In Part 1, I shared statistics from the National Institute of Mental Health, comparing the suicide rates for males and females at various ages:

Even during our youth where suicide rates are relatively low, males are still more likely to die by suicide than are females. It is also clear to me as my wife and I move into our 80s, that males and females face many challenges as we age, but it is older males who more often end their lives by suicide with rates 8 to 17 times higher rates than for females.   

In Part 2, I discussed the evolutionary roots of male/female differences and quoted Dr. Roy Baumeister,  one of the world’s leading social scientists. Understanding his work can better help us understand a lot about why men are the way they are and specifically why men are the risk-taking gender.

In his groundbreaking book, Is There Anything Good About Men? How Cultures Flourish By Exploiting Men, he says,

“If evolutionary theory is right about anything, it’s right about reproduction. Nature will most favor traits that lead to success at reproducing. But for thousands of years, men and women have faced vastly different odds and problems in reproducing. On this basic task, women faced good odds of success, whereas men were born to face looming failure.”

Men not only take greater risks than women, but also are less resilient and more prone to feelings of failure when they don’t feel they can offer something of value to those they love.

In Part 3, I show that suicide is the most prevalent form of violence and is the cause of more death than either war or homicide. We don’t often think of suicide as a form of violence or depression as an underlying cause of violence, but they are intimately related. The World Health Organization (WHO) produced an in-depth analysis of violence and published the information under the title, “The World Report on Violence and Health.” The report is the result of 3 years of work, during which WHO drew on the knowledge of more than 160 experts from more than 70 countries.

            The report detailed estimated global-related deaths as follows:

These numbers vary in different years and rates of violent deaths also vary according by country and within each country with different groups. But clearly violence from suicide accounts for nearly as many deaths as war-related violence and homicides combined. All forms of violence are tragic and many have come to believe that violence is simply a part of human nature. But this is not true.

Violence of all kinds can be understood and prevented.

“Violence thrives in the absence of democracy, respect for human rights and good governance,”

said Nelson Mandela. We often talk about how a ‘culture of violence’ can take root. This is indeed true—as a South African who has lived through apartheid and is living through its aftermath, I have seen and experience it. No country, no city, no community is immune. But neither are we powerless against it.”

As we approach another presidential election in the United States, most everyone is aware of the threat to democracy we are facing and the conflicts that divide our country.

In Part 4, I offered guidance for all those who are ready to see the truth about the times in which we live and how we can live, love, and work, for good in the world.

For most of my professional life I believed that treating depression and preventing suicide involved helping individuals, couples, and families. A new perspective opened for me in 1993 at a men’s leadership conference in Indianapolis, Indiana. I’ve written a number of articles about my experience over the years, including my most recent, “Transformations: The End of the U.S. and the World as We Know It and The Truth About Our Collective Future.”

I said that an old kind of masculinity was on the way out. My colleague Riane Eisler describes two competing systems that humans have been engaging with that she calls the dominator system and the partnership system. Throughout the world emotionally wounded men who ascend to power have chosen a dominator approach to asserting power.

            The old dominator systems were ruled by frightened men who came to believe that the only way to survive was to rule by force. Historian Ruth Ben-Ghiat describes these men in her book, Strongmen: Mussolini to the Present. She says,

“For ours is the age of authoritarian rulers: self-proclaimed saviors of the nation who evade accountability while robbing their people of truth, treasure, and the protections of democracy.”

            Among the seventeen protagonists in her book she includes: Adolph Hitler, Saddam Hussein, Benito Mussolini, Vladamir Putin, and Donald J. Trump. Pulitzer-Prize winning journalist Anne Applebaum describes the way modern-day autocrats support each other in her book, Autocracy Inc.: The Dictators Who Want to Run the World.

“Nowadays, autocracies are underpinned by sophisticated networks composed across multiple regimes…The autocrats are rewriting the rules of world trade and governance as their propagandists pound home the same messages about the weakness of democracy and the evil of America.”

            At MenAlive I have been supporting men and their families to embrace the partnership system and have recently created a way for organizations and individuals to belief in these ideas and practices to stay connected. You can learn more at our website, MoonshotforMankind.org and get news you can use on our substack, substack.com/@moonshotformankind.

            If you’d like to read more articles on men’s mental, emotional, and relational health, you can subscribe for free at https://menalive.com/email-newsletter/.

Every suicide is a tragedy that affects families, communities and entire countries and has long-lasting effects on the people left behind.

Suicide does not just occur in high-income countries but is a global phenomenon in all regions of the world. In fact, close to three quarters (73%) of global suicides occurred in low- and middle-income countries in 2021.