[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"doc-seo-454869-105":3,"detail-sidebar-cat-0-en-105":80,"doc-detail-454869-en":130},{"code":4,"msg":5,"data":6},0,"ok",{"site_id":7,"language":8,"slug":9,"title":10,"keywords":11,"description":12,"schema_data":13,"social_meta":73,"head_meta":75,"extra_data":77,"updated_unix":79},105,"en","from-outbreak-to-opportunity-sierra-leones-mpox-crisis-as-a-wakeup-call-for-pandemic-equity","From outbreak to opportunity - Sierra Leone’s mpox crisis as a wakeup call for pandemic equity","","The 2025 clade IIb mpox outbreak in Sierra Leone, occurring alongside a major HIV burden, is presented as more than a health emergency: it exposes persistent global health inequities. The commentary analyzes disparities in clinical outcomes, diagnostic and therapeutic access, and containment policies, criticizing a reactive charity-based model. It calls for proactive equity supported by a permanent infectious disease Equity Fund to enable rapid, fair vaccine, therapeutics, and diagnostics distribution during future outbreaks.",{"@graph":14,"@context":72},[15,34,55],{"@type":16,"itemListElement":17},"BreadcrumbList",[18,23,27,31],{"item":19,"name":20,"@type":21,"position":22},"https://docshare.wps.com","Home","ListItem",1,{"item":24,"name":25,"@type":21,"position":26},"https://docshare.wps.com/document/","Document",2,{"item":28,"name":29,"@type":21,"position":30},"https://docshare.wps.com/document/healthcare/","Healthcare",3,{"item":32,"name":10,"@type":21,"position":33},"https://docshare.wps.com/document/from-outbreak-to-opportunity-sierra-leones-mpox-crisis-as-a-wakeup-call-for-pandemic-equity/454869/",4,{"url":32,"name":10,"@type":35,"image":36,"author":41,"headline":10,"publisher":44,"fileFormat":47,"inLanguage":8,"description":12,"dateModified":48,"datePublished":49,"encodingFormat":47,"isAccessibleForFree":50,"interactionStatistic":51},"DigitalDocument",{"url":37,"@type":38,"width":39,"height":40},"https://docshare.wps.com/thumbnails/from-outbreak-to-opportunity-sierra-leones-mpox-crisis-as-a-wakeup-call-for-pandemic-equity/454869.png","ImageObject",300,407,{"name":42,"@type":43},"Stanley","Person",{"url":19,"name":45,"@type":46},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":52,"interactionType":53,"userInteractionCount":30},"InteractionCounter",{"@type":54},"ViewAction",{"@type":56,"mainEntity":57},"FAQPage",[58,64,68],{"name":59,"@type":60,"acceptedAnswer":61},"What does the commentary argue about the Sierra Leone mpox outbreak and global health inequity?","Question",{"text":62,"@type":63},"It argues the outbreak shows deep-seated global health inequities, with marginalized populations neglected until outbreaks threaten high-income countries.","Answer",{"name":65,"@type":60,"acceptedAnswer":66},"How do mpox and advanced HIV interact according to the text?",{"text":67,"@type":63},"Mpox is often self-limiting in immunocompetent people but becomes “debilitating and life-threatening” for people with untreated or advanced HIV, with many patients showing very low CD4 counts.",{"name":69,"@type":60,"acceptedAnswer":70},"What solution does the commentary propose to improve future outbreak responses?",{"text":71,"@type":63},"It proposes establishing a permanent infectious disease Equity Fund to ensure rapid, equitable distribution of vaccines, therapeutics, and diagnostics for future outbreaks.","https://schema.org",{"og:url":32,"og:type":74,"og:title":10,"og:site_name":45,"og:description":12},"article",{"robots":76,"canonical":32},"index,follow",{"doc_id":78,"site_id":7},454869,1790741556,{"code":4,"msg":81,"data":82},"success",[83,87,91,95,100,105,109,114,119,122,126],{"id":22,"doc_module":4,"doc_module_name":25,"category_name":84,"show_sort_weight":85,"slug":86},"Story & Novel",90,"story-novel",{"id":26,"doc_module":4,"doc_module_name":25,"category_name":88,"show_sort_weight":89,"slug":90},"Literature",80,"literature",{"id":33,"doc_module":4,"doc_module_name":25,"category_name":92,"show_sort_weight":93,"slug":94},"Exam",70,"exam",{"id":96,"doc_module":4,"doc_module_name":25,"category_name":97,"show_sort_weight":98,"slug":99},5,"Comic",60,"comic",{"id":101,"doc_module":4,"doc_module_name":25,"category_name":102,"show_sort_weight":103,"slug":104},6,"Technology",50,"technology",{"id":106,"doc_module":4,"doc_module_name":25,"category_name":29,"show_sort_weight":107,"slug":108},7,40,"healthcare",{"id":110,"doc_module":4,"doc_module_name":25,"category_name":111,"show_sort_weight":112,"slug":113},8,"Research & Report",30,"research-report",{"id":115,"doc_module":4,"doc_module_name":25,"category_name":116,"show_sort_weight":117,"slug":118},9,"Religion & Spirituality",20,"religion-spirituality",{"id":117,"doc_module":4,"doc_module_name":25,"category_name":120,"show_sort_weight":117,"slug":121},"World Cup","world-cup",{"id":123,"doc_module":4,"doc_module_name":25,"category_name":124,"show_sort_weight":123,"slug":125},10,"Lifestyle","lifestyle",{"id":127,"doc_module":4,"doc_module_name":25,"category_name":128,"show_sort_weight":96,"slug":129},19,"General","general",{"code":4,"msg":81,"data":131},{"doc_id":78,"user_id":132,"nickname":42,"user_avatar":133,"doc_module":4,"category_id":106,"category_name":29,"doc_title":10,"doc_description":12,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":30,"is_deleted":4,"is_public":22,"is_downloadable":22,"audit_status":22,"page_count":30,"language":139,"language_code":8,"site_id":7,"html_lang":8,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":12,"update_tm":79,"read_time":110,"preview_page_count":4},2336477405376,"https://ap-avatar.wpscdn.com/davatar_29158cc5080c5b710cf443261637dec0","Bai-Sesay et al. International Journal for Equity in Health (2026) 25:2  \n[https://doi.org/10.1186/s12939-025-02725-7](https://doi.org/10.1186/s12939-025-02725-7)  \nInternational Journal for Equity in Health  \nCOMMENT Open Access  \nFrom outbreak to opportunity: Sierra Leone’smpox crisis as a wakeup call for pandemic equity  \nAlpha Umaru Bai-Sesay 1,2,3*, Rosetta Doreen Jones 1,3 and Daniel Karim Dauda Sesay 1,3  \nAbstract  \nThe 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.  \nKeywords Health equity, Mpox, HIV, Sierra Leone, Global health, Pandemics, Health policy  \nThe convergence of two pandemics  \nThe World Health Organization’s situation reports often reduce human suffering to statistics. The figure of over 4,800 confirmed mpox cases in Sierra Leone in the first half of 2025 is one such statistic [1, 2]. Behind it lies amore harrowing truth: the devastating synergy of mpox and advanced HIV disease. As detailed in a recent Lancet correspondence, while mpox is often self-limiting in immunocompetent individuals, it becomes a “debilitating and life-threatening” infection for those with untreated or advanced HIV [1]. In one treatment center in Freetown, a staggering 83% of admitted mpox patients were co-infected with HIV, the majority presenting with CD4  \n*Correspondence:  \nAlpha Umaru Bai-Sesay  \n[umarbaisesay@gmail.com](umarbaisesay@gmail.com)  \n1Ministry of Health/National Public Health Agency, Freetown, Sierra Leone 2Research and Scientific Division, Sustainable Health Systems, Freetown, Sierra Leone  \n3Insights for Development Impact, Freetown, Sierra Leone  \ncounts below 200 cells per mm³ [1]. This confluence is not coincidental; it is diagnostic of a health systemstrained by historical underinvestment and a global apparatus that consistently fails the most vulnerable.  \nAlthough 5% of cases occurred in children, the overwhelming burden fell on a marginalized adult population, those living with HIV who are systemically failed by fractured care systems. The authors of the Lancet correspondence note that most patients were either newly diagnosed with HIV or had interrupted treatment, a direct consequence of the worldwide budget cuts that impede consistent access to HIV services [1]. This outbreak, therefore, is not a new problem but a symptom of a chronic one: the structural inequity that determines whois protected from pandemics and who is left exposed.  \nDisparities in care beyond the virus  \nThe clinical presentation of mpox in immunocompromised patients in Sierra Leone, characterized by large, necrotic lesions and protracted courses is a biological  \n© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is no","cbCaig6OM7UBKvgq","https://ap.wps.com/l/cbCaig6OM7UBKvgq","pdf",839392,"English","# The convergence of two pandemics\n## Impacts of mpox on advanced HIV\n## Structural inequity revealed\n# Disparities in care beyond the virus\n## Lack of key therapeutics\n## Isolation policies and stigma","[{\"question\":\"What does the commentary argue about the Sierra Leone mpox outbreak and global health inequity?\",\"answer\":\"It argues the outbreak shows deep-seated global health inequities, with marginalized populations neglected until outbreaks threaten high-income countries.\"},{\"question\":\"How do mpox and advanced HIV interact according to the text?\",\"answer\":\"Mpox is often self-limiting in immunocompetent people but becomes “debilitating and life-threatening” for people with untreated or advanced HIV, with many patients showing very low CD4 counts.\"},{\"question\":\"What solution does the commentary propose to improve future outbreak responses?\",\"answer\":\"It proposes establishing a permanent infectious disease Equity Fund to ensure rapid, equitable distribution of vaccines, therapeutics, and diagnostics for future outbreaks.\"}]","From outbreak to opportunity - Sierra Leone’s mpox crisis as a wakeup call for pandemic equity | PDF"]