Madagascar reported 703 of the world's 1,370 confirmed cases of mpox, a viral disease related to smallpox that causes painful skin lesions, in July, according to the World Health Organization (WHO) situation report 691. By 16 August the island had 3,436 confirmed cases, with 22 deaths, in 75 of its 115 districts, all of them clade Ib. That lineage of the more severe clade I virus was first identified in eastern DR Congo in 2023.
Two in three tests came back positive in the latest week, which means laboratories are seeing the obvious cases and missing many of the rest; WHO reads it as "insufficiently sensitive surveillance". Cases run across all ages and both sexes, a general-population pattern unlike the sexual-network spread behind Europe's local clade I transmission reported in June; there the clade I count stopped rising the same month. WHO cites vaccine stockouts and broken cold chains, the refrigerated supply lines vaccines need, and 111,508 people have had at least one dose.
On 27 August the International Coordinating Group on Vaccine Provision (ICG), the body that rations emergency vaccine stocks, launched a permanent mpox vaccine stockpile. The United Nations Children's Fund (UNICEF) procures the doses and Gavi (the alliance that funds vaccines for poorer countries) pays for them. Countries could request doses from September, replacing the ad hoc allocation system built in 2024. WHO also extended its standing mpox recommendations under the International Health Regulations (the binding treaty on outbreak reporting) to August 2027.
