INTRODUCTION:
Mpox remains an evolving threat to health security in West Africa, driven by recurrent cross-border transmission, delayed community-level detection, and constrained laboratory confirmation capacity in several countries. Recent analyses describe a changing epidemiological profile of Mpox across Africa, characterised by recurrent outbreaks, evolving transmission dynamics, and persistent surveillance and response gaps.¹ The high degree of population mobility, porous borders, and interconnected health systems across the ECOWAS region amplifies the risk of rapid multi-country spread. During 2024 – 2025, repeated outbreaks highlighted marked heterogeneity in national surveillance performance and response capacity, underscoring the need for strengthened regional coordination mechanisms to support timely detection, information sharing, and harmonised response.²

METHODS:
A mixed-methods assessment was conducted using Mpox surveillance data reported by Member States between January 2024 and December 2025. Quantitative data were obtained from national routine surveillance systems, laboratory reports, epibulletins, event-based epidemic intelligence, and regional situation updates. Key indicators including detection-to-notification timelines, laboratory confirmation rates, geographic spread, and cross-border coordination activities, were analysed before and after the implementation of regional coordination interventions. Qualitative inputs from multidisciplinary outbreak response teams were used to contextualise operational challenges, coordination processes, and field-level implementation.

RESULTS:
Strengthened regional coordination mechanisms were associated with shorter detection-to-notification timelines, improved laboratory confirmation through an expanded regional reference and referral network and increased joint investigations in high-risk border and high-mobility districts. Deployment of multidisciplinary surge teams supported national authorities in strengthening case finding, contact tracing, infection prevention and control, and risk communication. Persistent challenges included variable surveillance data quality across countries and delays in specimen referral in remote areas.

CONCLUSIONS:
Effective regional coordination can accelerate multi-country outbreak detection and response in interconnected settings. Strengthening regional governance, interoperable surveillance and laboratory systems, and One Health integration is critical for improving Mpox control and advancing pandemic preparedness across West Africa.