The country at the center of a global health emergency is struggling even to diagnose cases and provide basic care.

Health officials in the Democratic Republic of Congo, the epicenter of a shape-shifting mpox outbreak, say they lack even the most basic tools necessary to contain and treat the virus.

The country has limited capacity to diagnose cases of mpox, even as transmission and the presentation of the disease are changing. That is complicating efforts to trace contacts and establish the true scale and spread of the outbreak.

There is no effective antiviral treatment for mpox in Congo. The country is also short on the medications necessary to treat people with painful mpox lesions. Its fragile public health system is struggling to provide those infected with basic care, which has been shown to improve survival rates even in the absence of antiviral drugs.

And the country is still waiting for vaccines to begin a campaign to protect health workers and close contacts of those infected and to try to check spread of the virus.

“We thought when there was an emergency declaration from the World Health Organization in 2022 that then we would get help with surveillance and really understanding this disease,” said Dr. Jean-Jacques Muyembe-Tamfum, the director of the National Institute of Biomedical Research in Kinshasa.

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