What is this policy brief about?

This brief provides a reflection on South Africa’s National Guidelines for the Clinical Recognition, Diagnosis, and Management of mpox, which were released in 2025. It highlights key strengths of the guidelines – such as improved case definitions, diagnostic pathways, and integrated HIV/STI management – while also identifying important gaps and implementation challenges. This brief is designed to improve awareness and understanding of South Africa’s 2025 national mpox guidelines. It provides a structured overview and practical interpretation of the guideline contents. By breaking down these components, the brief aims to make the guidelines more accessible and actionable for healthcare workers and public health practitioners.

Why does this matter?

Mpox has evolved from a historically rare zoonotic disease into a global public health concern, with cases reported across more than 140 countries since 2022. Although South Africa has experienced relatively low case numbers since 2022, the risk of importation and local transmission remains, as the circulation of the mpox virus remains elsewhere. Strengthening preparedness through clear, evidence-based national guidelines is essential to ensure early detection, appropriate clinical management, and effective outbreak response.  Guidelines are only effective if they are understood and implemented consistently. While South Africa has developed comprehensive national mpox guidelines, there is a need to ensure that healthcare workers across all levels of the health system are familiar with their content and implications. This brief helps bridge that gap by translating technical guidance into practical insights that support day-to-day clinical decision-making and public health action.

How did this policy brief come about?

The policy brief emerged following the release of the national mpox guidelines in August 2025 by the National Department of Health. The guidelines are comprehensive, but their effective implementation requires a clear understanding of how the different components fit together in practice. This brief was therefore developed to unpack the guidelines, highlight key messages, and outline their implications for implementation within South Africa’s health system.

What was your role in the development of this policy brief?  

As the lead author, I guided the development of the brief to ensure it aligns with national priorities and responds to implementation needs. This involved synthesising the guideline content into a more accessible format, identifying key operational considerations, and ensuring that the document speaks to clinicians, laboratorians, and public health practitioners alike. The goal was to provide a practical lens through which the guidelines can be understood and applied.

Why should people read this article?

This article is particularly valuable for healthcare workers, programme managers, and policymakers who are responsible for implementing the mpox guidelines. It provides a concise and practical breakdown of the guidelines and their implications. By distilling complex guidance into key take-home messages, the brief supports more improved awareness and implementation of the guidelines.

What impact do you hope this article will have on public health policy and healthcare access?

We hope this article will enhance the uptake and consistent application of the national mpox guidelines across South Africa. By improving awareness and understanding, it can contribute to earlier case detection, more appropriate clinical management, and stronger surveillance systems. Ultimately, this should support more equitable access to care and a more coordinated public health response to mpox and future emerging infectious diseases.

Dr Jacquiline Weyer is the Head of the Centre for Emerging Zoonoses and Parasitic Diseases at the National Institute for Communicable Diseases.

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