WHO’s Multi-country External Situation Report No. 45 (January 11, 2025) outlines the ongoing global Mpox outbreak with a focus on clade Ib MPXV. 

In central Africa, the DRC, Burundi, and Uganda remain key hotspots, with community transmission and weekly case numbers of 100–200. For instance, the DRC recorded 2,464 cases (5 deaths) over six weeks, while Uganda and Burundi reported significant numbers, although December festivities likely reduced surveillance. 

Internationally, travel-associated cases emerged in 11 non-African countries, including instances in Germany, the UK, China, and others, with some countries like Tanzania and the UAE suspected of undetected spread. 

The report differentiates clade dynamics: clade Ia in the DRC is zoonotic but now increasingly human-transmitted; clade Ib is spreading rapidly via human contact; clade IIa is newly observed in West Africa; and clade IIb continues at low levels globally, primarily among MSM. 

Africa saw 14,700 cases (66 deaths) over one year amid shifting demographics. WHO emphasizes bolstering surveillance, vaccination (87,000 doses in the DRC, 4.83 million doses for 2025), and cross-border collaboration, deeming clades Ib and Ia high risk. Additionally, ongoing trials indicate limited efficacy of tecovirimat for mild cases, prompting updated infection prevention protocols and expanded decentralized testing in resource-constrained areas.