In August 2024, the World Health Organization (WHO) declared mpox a Public Health Emergency of International Concern (PHEIC) following a sharp rise in cases across Central Africa. The Democratic Republic of the Congo (DRC) has been the hardest hit, reporting over nearly 18,000 confirmed cases in 2024 & 2025. Neighbouring countries, including Cameroon, the Republic of Congo, and the Central African Republic, have also seen significant outbreaks, underscoring the urgency of the situation.

Elrha's Rapid Response

We have a long history of supporting research and innovation in infectious disease outbreaks, including in Ebola, COVID-19 and cholera.  When the PHEIC was declared, we quickly mobilised to assess how we could leverage our funding mechanisms to help contain the epidemic. Recognising the need for a rapid and impactful approach, we determined that a direct grant mechanism would be the most effective use of our resources.  

We reached out to our extensive network at global, regional and country levels to identify the key research and innovation needs.  While biomedical research-particularly experimental vaccines and therapeutics- was receiving significant attention (rightfully so!), we identified a major gap in social and behavioural science (SBS) for this outbreak response.  SBS in this context refers to research to better understand how individuals, communities, and societies perceive, respond to, and are affected by outbreaks of infectious disease (in this case, mpox).  Given we had already funded lots of excellent SBS work for other outbreaks (see on COVID-19, and on Ebola - an anthropology response platform, development of community-informed messaging, community-feedback mechanisms), we were confident that we could support this area of work yet again.  

We also came to realise very quickly that it wouldn’t be possible to divorce the outbreak event from the pre-existing humanitarian crises in the region, particularly in the Eastern region of DRC, and that this was where we should focus our efforts.  Our decision to focus there has become all the more relevant given the recent insecurity.

Convening experts in Kinshasa

In collaboration with WHO’s Community Protection in Health Emergencies, the Africa Centre for Disease Control and Prevention, and Global Health EDCTP3, we co-designed and funded a pivotal convening event in Kinshasa, DRC, that took place in November 2024, with support from FCDO. The gathering brought together biomedical and SBS researchers, outbreak response leaders, and civil society to redefine the role of SBS in outbreak response. The aim was to establish SBS as a foundational pillar—working alongside epidemiological and biomedical approaches—to address not just the mpox pathogen but also the societal and behavioral factors shaping the epidemic’s trajectory. A report summarising the key insights and recommendations from that meeting will be released very shortly and we will share when it is!

New research projects to strengthen the mpox response

We are excited to announce the selection of three new projects for funding, each with a huge potential to really help turn the corner on the mpox epidemic:  

1. WHO-led community engagement and research initiative

• Building a community of practice: We will support WHO in establishing an ongoing community of practice to keep the conversation going with those who attended that meeting (and beyond. Do let us know if you’re working in this area and want to get involved), to ensure that the recommendations from that meeting are followed up and implemented.  

• Operational SBS research: In partnership with the DRC Ministry of Health and three Goma-based academic institutions (Université Catholique la Sapienta de Goma, Université Libre des Pays des Grands Lacs & Ecole Sante Publique), WHO will conduct rapid operational social and behavioural science (SBS) research on key community protection questions derived directly from mpox response evidence gaps.  By employing a flexible, multi-wave design, the research will focus on rapid, context-specific data collection and analysis, prioritising equity, inclusion, and the needs of vulnerable communities while embedding efforts within the existing public health response structure.  

• Developing a generalisable SBS protocol: The project will also work to develop a generalisable SBS protocol for future outbreaks of infectious disease, to support the rapid generation of action-oriented, community-centred research findings for response. This will be a global good, that comes with an implementation framework, so that organisations worldwide can ensure that the needs and priorities of communities affected by outbreaks are at the centre of response action.

2. Vaccine acceptance and community sensitisation study

• Our grant to a consortium made up of the University of Manitoba, the University of California at Los Angeles and the Institute National de Recherche Biomedical in DRC will look at mpox vaccine acceptance, knowledge, and risk perception among at-risk groups and affected communities in Eastern DRC.

• The study will include pre- and post-vaccination evaluations, followed by a targeted community sensitisation campaign to raise awareness and address concerns.  

• The findings will be shared with humanitarian health actors to strengthen vaccine deployment strategies and shape future public health messaging.  Given the number of vaccines being rolled out in DRC, understanding public perceptions is crucial to ensuring effective immunisation efforts.  

3. Research uptake for ethical community participation

• This initiative will recentre the learning from a previous grant (on ethical community participation in Ebola trials from the West Africa Ebola outbreak) to the DRC mpox context. We aim to adapt and apply these learnings to the DRC mpox context, ensuring ethical engagement and meaningful community involvement in outbreak response efforts.

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Moving forward: a community-driven, evidence-based response

These projects are designed to fill critical evidence gaps identified by those tackling mpox on the frontlines.  We recognise the challenges of working with partners in areas where security and operational conditions are highly fluid. However, funding research and innovation in fast-moving humanitarian contexts is our very raison-d'etre, and thus we aim to be as flexible as we can to accommodate changes in local realities.  

By bridging these gaps and fostering collaboration between local, regional, and global partners, we are ensuring that the mpox response is not only evidence-based but also community-driven, ethical, and inclusive. At Elrha, we are deeply committed to supporting research that places affected communities at the centre of decision-making and response.  

We look forward to sharing the transformative insights and outcomes from these efforts in the coming months—together, we can turn the tide on this epidemic.

Image credit
Two health workers testing MediCapt. Photo by Adriane Ohanesian / Physicians for Human Rights.