From outbreak to opportunity: Sierra Leone’s mpox crisis as a wakeup call for pandemic equity

TL;DR

The mpox outbreak in Sierra Leone highlights global health inequities and calls for a new approach to pandemic preparedness focused on fairness.

Contribution

The paper proposes a permanent Equity Fund to ensure fair access to health resources during future outbreaks.

Findings

The mpox outbreak in Sierra Leone reflects long-standing neglect of marginalized populations in global health.

Current containment strategies and resource distribution are reactive and unequal.

A proactive, equity-centered model is needed to prevent future health crises.

Abstract

The 2025 clade IIb mpox outbreak in Sierra Leone, intersecting with a significant HIV burden, is not merely a health crisis but a stark manifestation of deep-seated global health inequities. This commentary argues that the response to this outbreak reveals a familiar and fatal pattern: the neglect of diseases within marginalized populations until they threaten high-income countries. Through analyzing disparities in clinical outcomes, diagnostic and therapeutic access, and containment policies, we critique the reactive, charity-based model of global health. We propose a paradigm shift towards proactive equity, centered on the establishment of a permanent infectious disease Equity Fund to ensure the rapid, equitable distribution of vaccines, therapeutics, and diagnostics for future outbreaks, transforming a moment of crisis into an opportunity for durable change.