…Raise Questions About the Health System’s Readiness
By Amos Harris
MONROVIA, LIBERIA — Liberia’s public health system is facing intense scrutiny following a disturbing surge in Mpox infections nationwide. Since September 2024, the Ministry of Health (MOH) has reported over 2,400 suspected cases, with more than 1,300 infections confirmed, exposing what critics argue are lingering weaknesses in the country’s capacity to manage emerging diseases.
In a situation update released on November 7, 2025, Chief Medical Officer Dr. Catherine T. Cooper confirmed that the virus remains active across multiple counties despite ongoing interventions in surveillance, case management, and public awareness. The Ministry’s data reveals a high positivity rate of 56.6 percent, signaling widespread community transmission that has now reached 65 of Liberia’s 98 health districts.
Montserrado County has emerged as the clear epicenter, accounting for 57 percent of all active cases. The infection rate is particularly high in the densely populated corridors of Bushrod, Central Monrovia, and Somalia Drive—areas frequently challenged by inconsistent healthcare access. Nimba County follows with 18 percent, Margibi with 7 percent, and Grand Bassa with 5 percent.
While the MOH reported 1,154 recoveries and a relatively low case fatality rate of 0.5 percent (six deaths), public health experts warn that this apparent success does not mitigate serious underlying systemic deficiencies. These gaps include critically limited testing capacity, inadequate funding for national surveillance, and a slow logistical response, especially in rural areas.
“The numbers might appear encouraging, but we are still seeing delays in case detection, testing, and treatment, particularly in remote districts,” one public health worker, speaking anonymously to maintain their employment, stated. “If the government doesn’t sustain community engagement and supply chain logistics, the situation could worsen rapidly.”
To counter the widening spread, the Ministry has launched a 90-day national response strategy slated from November 2025 to January 2026. This plan pledges to strengthen surveillance, expand treatment capacity, and intensify public education. Key actions include:
- Upgrading the Liberia Center for Infectious Disease Hospital with new diagnostic equipment and medical supplies.
- Refresher training for frontline health workers on Mpox management protocols.
- Achieving a target of testing all suspected cases within 48 hours and attaining zero preventable deaths by January 2026.
Crucially, the strategy includes the rollout of a preventive ring vaccination campaign in Montserrado and other high-transmission counties, scheduled to begin in December 2025. This follows Liberia’s receipt of 42,720 vaccine doses from an international consortium that includes the US CDC, Africa CDC, GAVI, and UNICEF, targeting adults aged 18 and above.
Despite the ambitious plan, concerns persist regarding funding and execution in Liberia’s heavily donor-dependent healthcare delivery system. Questions linger about the Ministry’s ability to effectively coordinate logistics, maintain the vaccine cold chain, and consistently reach underserved communities.
Civil society groups also point to a deficit in public trust, arguing that the government’s slow communication and lack of transparency have fueled misinformation and public fear.
“Communities need more than statistics; they need consistent education and trust,” a health advocate in Kakata noted. “People are still confused about how Mpox spreads and how they can protect themselves.”
The MOH has reactivated its Incident Management System for daily coordination and weekly audits of infection prevention efforts in hospitals. As the nation battles this new wave of Mpox, the government’s ability to execute its plan—and, in doing so, regain public confidence—will ultimately determine not just the fate of this current outbreak, but the credibility of its public health leadership going forward.
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