Medical staff examine a patient inside the new mpox treatment centre in Calaba Town, Freetown, a collaboration between the Sierra Leone’s Ministry of Health and MSF for the treatment of moderate and severe cases.Credit: MSF
Sierra Leone is in the grip of its worst mpox outbreak to date. Since the first case was confirmed in January, BY July 1 more than 4,489 infections and 29 deaths hd been recorded across all districts.
The national case fatality rate remains low, at 0.6%, but the scale and speed of transmission are straining the health system and raising regional concerns.
Factors like overcrowding, weak diagnostic capacity and widespread misinformation have allowed the virus to spread rapidly, especially in urban areas like Freetown. Médecins Sans Frontières (MSF) is working alongside Sierra Leone’s Ministry of Health to support treatment, surveillance and community engagement.
Htet Aung Ky, MSF’s medical coordinator in Sierra Leone.Credit: MSF
Describe the current mpox outbreak in Sierra Leone
Despite national efforts, the virus continues to spread, especially in dense urban centres. Our top priorities now are care for patients, infection prevention, and community education to reduce fear and stigma.
What is MSF doing on the ground to support the response?
We’re supporting Ministry of Health facilities in Bombali, Tonkolili and Kenema, and in Freetown, where the burden is highest. In June, we helped to open a dedicated 50-bed mpox treatment centre in Calaba Town, Freetown, to care for patients with moderate to serious illness. MSF is providing medical supplies, staffing support, logistics and overall management. We have also renovated the infectious disease isolation ward at Connaught Hospital, and improved laboratory capacity by donating a generator to the Central Public Health Reference Laboratory. A local chlorine production unit has been installed to strengthen infection prevention and control (IPC) capacity, and lower costs. We continue to support health worker training, transport of samples and diagnosis logistics.
What are the biggest challenges in identifying and treating cases?
Stigma is a huge obstacle. We often hear of people refusing ambulance transport to avoid being seen by neighbours. Many arrive at treatment centres late, with painful wounds that require intensive nursing care, pain relief, nutrition and psychosocial support. These cases are complex and resource-intensive, and require a coordinated, patient-centred approach.
Are health workers adequately protected?
We’ve made IPC a cornerstone of our response. MSF has trained health workers in IPC measures, and supplied personal protective equipment (PPE) and hygiene kits to all facilities we support. The government has prioritised vaccination for frontline responders, which is vital, but more doses are urgently needed to ensure comprehensive coverage.
The Calaba Town mpox treatment centre in Freetown, Sierra Leone.Credit: MSF
Is misinformation a problem?
Misinformation and fear are fuelling stigma. We’ve seen patients avoid care for fear they will be rejected by their communities, even if they recover. This is why strong community engagement is so important: explaining how mpox spreads, what it is, and how people can protect themselves and one another without fear.
Has vaccine access improved?
So far, more than 45,000 people have been vaccinated, including health care workers, high-risk contacts and vulnerable groups. But supply is still insufficient. We need more doses, and fast. A strategic, data-driven rollout is essential to slow transmission and protect those most at risk.
From your perspective, what else is needed?
More than anything, we need sustained international support: technical, financial and logistical. The national response team is stretched thin. With the right resources, clinical care could be expanded, testing expanded and contact tracing improved, while stigma could be tackled through education. This outbreak can be contained. But we need the world to act now, both to support Sierra Leone and to help prevent future outbreaks elsewhere.
