UNICEF Puts Children Front And Center In Mpox Response

Thousands of children in the Democratic Republic of the Congo, Burundi and other countries in Africa are at severe risk of contracting the mpox virus as cases of the new variant — clade 1b — continue to surge. UNICEF and partners are scaling up the emergency response, but more donor support is needed.

UNICEF: In race to stem Africa’s mpox outbreak, prioritizing the needs of children is not just necessary — it’s urgent

As the number of mpox cases continues to rise across the Democratic Republic of the Congo (DRC), UNICEF is stepping up its support to the government to protect and save children’s lives.

UNICEF is also working with health authorities and partners in Burundi, where school-age children aged 5 to 19 now account for one-third of all mpox cases, to accelerate outbreak response measures there.

Interventions are focused on protecting and supporting children, pregnant women and underserved communities. Top priorities are to interrupt disease transmission, while also mitigating secondary impacts, such as school closures, which tend to heighten protection risks for already vulnerable children.

The DRC — a country facing one of the largest displacement crises in the world, and where 25 million people already need humanitarian assistance, including 15 million children — is the epicenter of the mpox crisis, recording more than 21,000 suspected cases since the beginning of the year, 5,000 confirmed cases and 700 deaths.

Children under age 15 account for about half of all suspected cases reported in DRC so far this year — and 80 percent of the deaths.

UNICEF DRC Deputy Representative Mariame Sylla traveled to the center of UNICEF’s response in South Kivu earlier this month.

“I … saw firsthand the difference our teams on the ground are making for children,” Sylla said. “I met a mother who was able to quickly get the free treatment needed for her 6-month-old daughter Merci after she caught the virus. But as case numbers rise and needs grow, we need to step up our efforts so that all children get the lifesaving care they need.”

Mpox outbreak one more crisis for already vulnerable families and communities

In Burundi, the risks for children are compounded largely by two parallel threats: measles and malnutrition. Shortages of diagnostic test kits and medicines, among other challenges, further complicate matters.

“The rising number of mpox cases among children in Burundi, including children under 5, is deeply concerning, and protecting them is our top priority,” said France Bégin, UNICEF Representative in Burundi.

Ensuring that all children can safely return to school is critical, Bégin added. “Our teams are working closely with the Ministry of Education to implement health measures in schools, safeguard students and prevent further learning disruptions.”

Driving the outbreak: a new variant of the monkeypox virus

Mpox, formerly known as monkeypox, is a highly contagious viral infection that can spread through direct contact with bodily fluids, respiratory droplets and contaminated surfaces or objects. Caused by the mpox virus, it is a zoonotic disease — meaning it can spread from animals to humans, as well as person to person or from the environment to people. Symptoms are similar to smallpox.

The 2022 monkeypox outbreak in Europe and the U.S. was different than the current outbreak in that it mainly affected adults.

This year’s outbreak was declared a public health emergency of international concern by the World Health Organization (WHO) on Aug. 14, a day after the Africa Centers for Disease Control and Prevention (Africa CDC) proclaimed it one of continental security. Children and vulnerable communities are at the sharp end.

Other countries where cases are being reported include Central African Republic (CAR), Kenya, Rwanda and Uganda. Action is required to prevent further spread in those countries as well, according to UNICEF’s emergency mpox appeal.

A treatable infection that can be fatal for children already sick or malnourished, or who lack access to health care

Person-to-person transmission of mpox occurs primarily by direct contact with infectious lesions on the skin or particles emitted when an infected person coughs or sneezes.

Children can be exposed at home or in the community through close contact with people who are symptomatic with mpox, including parents, caregivers and other family members. They can catch it by touching an infected person’s clothes or bedding.

Treatment includes skin care, hydration and nutrition support, pain and fever management, and management of any secondary bacterial infections should they occur. Children may be at greater risk of severe mpox than adults, and must be closely monitored until they have recovered in case they need additional care.

UNICEF and partners are working together to stop the spread of mpox, protect children from secondary impacts

UNICEF is part of a coordinated international effort to stop the outbreak and save lives, working with the Africa CDC, the WHO and other partners to support national governments in response planning and implementation.

In the DRC, UNICEF is leading on infection prevention and control, risk communication and community engagement, nutrition, mental health and psychological support, and operational research.

In recent months, UNICEF has:

• enhanced community-based surveillance, training over 200 health workers, 100 hygienists and 200 community engagement teams
• supported the deployment of 6,000 community workers to raise awareness and a related media campaign that had 30 local radio stations broadcasting public health messages
• supported community engagement teams who have already reached 46 million people across DRC with mpox messages via mass media, face-to-face engagement, SMS and digital channels
• set up mpox treatment and isolation units in busy health centers, including Kavumu and Lwiro in the Miti Murhesa health zone, offering free treatment
• distributed medical kits to health zones Kavumu, Lwiro, Kamanyola and Uvira, to Miti Murhesa General Hospital and Bukavu Central Prison

Limited access to WASH services in certain hotspots remains a challenge, putting health care personnel at risk.

In Burundi, UNICEF, as the lead partner in education and emergency preparedness, is providing technical support to the Ministry of Education to help prevent the spread of mpox in schools and to support affected children to reduce their risk of dropping out.

This includes training school staff to identify early symptoms of mpox and refer learners to care, reinforcing hand hygiene, and supplying essential resources to ensure safety and maintain educational momentum.

Other response efforts include engaging with communities, developing communication plans, training community health workers and implementing mass communication campaigns aimed at enhancing prevention and control at the household, health facility and community levels.

More than 800,000 people in Burundi were reached in the past month with mpox prevention messages delivered via radio broadcast, and WASH kits and personal protective equipment were distributed to nearly two dozen hospitals.

UNICEF is also providing hygiene supplies and medical kits, ensuring nutritional support for affected children, addressing stigma and discrimination and strengthening mental health and psychosocial support for children and caregivers.

Ensuring continued access to essential social services in communities affected by the outbreak is paramount.

“Many of the people affected by the mpox emergency were already facing multiple deprivations due to armed conflict, displacement and other disease outbreaks,” DRC Representative Sylla said. “The mpox response must not overlook pre-existing humanitarian needs, and any measures should serve to reinforce existing efforts.”

Exploring the use of vaccines to fight mpox part of a longer-term strategy

In early September, UNICEF DRC received the first shipments of the mpox vaccine, with more doses to arrive soon. UNICEF is supporting the vaccine roll-out in the country through related supplies and logistics and by training health workers in transportation, storage and administration of vaccines to patients.

Vaccines for mpox are relatively expensive and administering them requires special training. For these reasons, and due to the complex logistics of launching mass vaccination campaigns in many mpox hotspots, vaccination is not considered the primary solution to the current outbreak emergency, but rather part of a longer-term prevention strategy.

UNICEF is calling for an accelerated, well-coordinated and efficient response to mpox — one where children and communities are tested and provided supportive care to recover their health with dignity and free from stigma.

This includes ensuring that national primary health care services are strengthened and continuity of health and social services for children and pregnant women is ensured to avoid secondary harm and adverse socioeconomic impacts of mpox.

“The response to mpox must not overlook pre-existing humanitarian needs,” the appeal states. “[A]nd mpox prevention and response measures should be integrated into existing and/or planned humanitarian responses.”

While accelerating direct response efforts alongside partners in countries with active outbreaks, UNICEF is also closely monitoring the situation in Cameroon, Congo, Côte d’Ivoire, Gabon, Liberia, Nigeria and South Africa.

Flexible emergency funding will allow UNICEF and its partners to respond with agility to the greatest and most immediate needs in affected areas. Full funding will help to ensure that children and their families are treated for and protected from mpox and will help mitigate the many consequences of a major disease outbreak.

UNICEF’s mpox response plan in DRC covers 12 priority provinces, and aims to reach 2.38 million people, including 1.32 million children. The response plan for Burundi covers 16 priority districts, and aims to reach 1 million people, including 200,000 children and youth under age 20.

Learn more about UNICEF’s mpox response and related appeal to donors for support.

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