Why Uganda's Outbreak Looks Different Uganda's first confirmed mpox cases surfaced in July 2024, in two women at a hospital near the DRC border. By January 2025, cases had surged to over 2,100 nationally, nearly 70% of them concentrated in the Kampala metropolitan area alone. Dr. Henry Kyobe, Uganda's National Incident Manager for mpox, explained that transmission was disproportionately concentrated among sex workers, their mobile networks, and close contacts including commuter taxi drivers and boda boda riders, though he stressed cases weren't confined to any single social group. Frequent cross-border movement with DRC and risky sexual behaviour in fishing communities compounded the spread, alongside Kampala's sheer population density. A Vaccination Strategy Built Around Stigma, Not Just Supply Uganda's response leaned heavily on reaching populations mainstream health campaigns routinely miss. When 10,000 doses of the MVA-BN vaccine arrived from the European Union's health emergency agency in January 2025, the rollout deliberately targeted two Kampala divisions, Kawempe and Makindye, through what officials called a ring vaccination strategy built on peer-to-peer mobilisation rather than clinic walk-ins. WHO partnered with a local clinic to run "moonlight vaccination" sessions timed to when sex workers and their clients were actually available, a small operational detail that significantly boosted acceptance: vaccination coverage in Kampala and Mbarara eventually reached 73%, with women making up 56% of those vaccinated. For sex worker Chantel Mbabazi, the outbreak's disruption was immediate and personal. "Sex workers' business is being spoiled," she said, describing how fear of infection had reshaped her livelihood alongside her health risk. What the Continental Joint Plan Actually Did The WHO and Africa CDC response ran on a 10 pillar framework spanning surveillance, laboratory capacity, vaccination, and integration of mpox care into routine health services rather than treating it as a permanent standalone emergency. That framework drove real gains in DRC's diagnostic testing capacity, achieved despite active conflict and insecurity in the country's eastern regions. Enhanced infection prevention and control efforts had cut mpox infections among healthcare workers by 50% since November 2024. A second continental vaccination round was underway by April 2025, concentrated in five Ugandan districts and specifically targeting sex networks, long distance drivers, and fishing communities, the same population groups Uganda's own ring vaccination strategy had already identified as the outbreak's real transmission core. A 3 week old girl suffering from mpox in the emergency room at Kavumu Hospital, South Kivu, DRC, August 30, 2024. Credit: WHO/Guerchom Ndebo. The Funding Gap Behind the Divergence WHO said $220 million was still needed to close funding shortfalls in the response, compounded by humanitarian aid cuts globally. Whether Uganda's worsening trajectory reflected genuinely different transmission dynamics, or simply where funding and vaccine doses had and hadn't reached yet, was the open question heading into Africa CDC's planned May 17 emergency committee review. A Wider Health Picture The same briefing revealed how much else Africa CDC was juggling simultaneously: an anthrax outbreak in Uganda since January (16 cases, six districts), an anthrax outbreak among hippopotamuses in DRC's Virunga National Park with animal deaths spreading into South Sudan and Uganda, an 11.5% weekly rise in Angola's cholera outbreak, and Uganda's Ebola outbreak nearing its formal end, pending 11 more days without a new case. _Reporting sources: CIDRAP (Lisa Schnirring, 17 April 2025); WHO official statement, 17 April 2025; UNICEF Uganda Humanitarian Situation Report (30 April 2025); WHO/AFRO; Gavi.org; PMLDaily; PMC._ Editor's note, added January 2026: The emergency committee's May 17, 2025 review recommended keeping the emergency status in place, as did a subsequent review that September, with Africa CDC's advisory group warning that lifting it prematurely risked complacency and a funding pullback. The Public Health Emergency of Continental Security was ultimately lifted on January 23, 2026, after the response had mobilized more than $1 billion in financing, deployed over 5 million vaccine doses across 16 countries, and driven confirmed cases down 60% from their peak. Announcing the decision, Kaseya called it proof of "Africa's growing capacity to manage complex public health challenges." Mpox remains a health concern in parts of the continent even after the formal emergency ended. Update sources: Africa CDC (2 September 2025; 23 January 2026); AllAfrica.