MONROVIA, LIBERIA – On Thursday, November 14, 2024, Dr. Dougbeh Chris Nyan, Director-General of the National Public Health Institute of Liberia (NPHIL), held a significant press briefing at NPHIL’s headquarters in Congo Town, Monrovia, to inform the Liberian public on critical health issues, including the recent outbreak of monkeypox (MPOX) and Liberia’s expanded disease detection and response capabilities. Dr. Nyan emphasized the importance of public awareness and transparency, particularly concerning Liberia’s position on the African continent, where health crises can quickly evolve due to cross-border transmissions and resource limitations.
Dr. Nyan opened the briefing with a message of reassurance, emphasizing that NPHIL’s ongoing mission is to keep the public informed while avoiding unnecessary panic. This balance, he explained, is critical to instilling confidence in both Liberian citizens and the country’s international partners, especially as Liberia continues to work toward preparedness and rapid response in the face of emerging health threats. Since August, MPOX has posed a unique challenge in the region, but Dr. Nyan assured the public that NPHIL has been consistently reporting its updates to the World Health Organization (WHO) and the Africa Centres for Disease Control and Prevention (Africa CDC).
Addressing Liberia’s ongoing battle with MPOX, Dr. Nyan reported a total of 41 cases this year, with zero deaths. He emphasized the importance of highlighting recoveries and the institute’s success in disease management, as these factors reflect the strength of Liberia’s public health interventions. Currently, Liberia has 22 active MPOX cases, of which 19 have fully recovered. According to Dr. Nyan, active cases are carefully managed through both isolation centers and home-based care, depending on the severity and conditions of the patients involved.
Furthermore, Dr. Nyan revealed that 12 of these confirmed cases are spread across counties near international borders, including Nimba, Lofa, and Grand Bassa, among others. He detailed Liberia’s epidemiological challenges, which are amplified by its geographical proximity to the Ivory Coast, another hotspot for MPOX cases. This cross-border transmission risk has heightened the vigilance and preparedness measures by the NPHIL, especially in counties where animals, potentially serving as viral reservoirs, interact closely with human populations.
In an effort to expand Liberia’s capacity to identify and understand virus strains more precisely, Dr. Nyan announced that NPHIL has successfully implemented in-country genetic sequencing capabilities for the MPOX virus. Previously, Liberia relied on laboratories in Nigeria and the United States for sequencing, a process that took several weeks. Now, with the aid of international organizations, Liberia’s public health scientists can conduct sequencing locally, saving crucial time in the diagnostic and response phases of outbreak management. Dr. Nyan lauded his team for their achievement, stating that this newfound capability not only aids in identifying the virus strain but also paves the way for broader disease control across Liberia.
Dr. Nyan attributed this development to a collective effort, acknowledging the support of the WHO, Africa CDC, the U.S. CDC, and other international health partners, as well as the encouragement of President Joseph Boakai. He commended President Boakai’s vision for revitalizing Liberia’s healthcare infrastructure and expressed appreciation for his support in positioning NPHIL as a leader in public health research and crisis response. This shift allows Liberia to independently sequence cases and immediately apply findings, which is essential for Liberia’s goal of becoming more self-reliant in managing public health emergencies.
Liberia’s capability for in-country sequencing has already proven valuable, with Dr. Nyan confirming the detection of two distinct MPOX virus clades in Liberia: Clade 2A and Clade 2B. He credited Liberia’s young scientists, whom he praised for their role in the sequencing project, as crucial contributors to Liberia’s growing public health sector. With this success, NPHIL has also strengthened its national diagnostic infrastructure, which will play a critical role in responding to current and future public health threats.
Beyond MPOX, Dr. Nyan informed attendees about the presence of multiple other infectious diseases under surveillance, such as measles, Lassa fever, and yellow fever, which have periodically emerged in isolated areas. He acknowledged that while these outbreaks are not widely publicized due to their localized impact, NPHIL’s comprehensive surveillance and management measures ensure that they remain under control. This commitment to addressing both widespread and isolated health threats reflects Liberia’s ambition to build a more resilient health system capable of managing diverse challenges.
In a related issue, Dr. Nyan addressed the recent cross-Atlantic transmission of Lassa fever, following the case of a 54-year-old American patient who visited Liberia and later tested positive for Lassa fever upon returning to the United States. The case, which involved cooperation between the U.S. CDC and NPHIL, has prompted Liberia to enhance its contact tracing protocols and deepen its genomic investigations to track potential sources and transmission pathways of the virus. Dr. Nyan emphasized that understanding the viral lineage is essential for containing Lassa fever and mitigating its spread both within and beyond Liberia’s borders.
Elaborating further, Dr. Nyan discussed the complex ecology of Lassa fever transmission. He explained that environmental changes, such as deforestation, have likely disrupted habitats for certain rat species that harbor the virus, causing them to migrate to new regions and, in turn, expanding the Lassa fever “belt” within Liberia. This phenomenon, Dr. Nyan noted, illustrates how ecological factors play a role in public health and reinforces the need for interdisciplinary approaches to disease prevention and control.
On an international level, Dr. Nyan reported that Liberia recently participated in collaborative meetings with health leaders from across Africa. At these gatherings, countries shared strategies and discussed how best to respond to shared health threats. Liberia’s participation was particularly valuable, given its unique experience in managing MPOX cases in rural areas with limited healthcare access. Dr. Nyan highlighted Liberia’s role in establishing collaborative agreements with Uganda, Rwanda, and Kenya to foster a network for rapid response, research, and resource-sharing in case of future outbreaks.
During one of these international summits, African health leaders agreed to form a continental disease repository for preserving virus samples and diagnostic data from across the region. This repository aims to make samples readily available for research, diagnostics, and other scientific purposes, strengthening Africa’s collective capacity to respond to emerging diseases. Dr. Nyan stated that Liberia has been appointed to a steering committee for this initiative, underscoring the country’s growing influence in regional public health policy.
To conclude the briefing, Dr. Nyan reiterated NPHIL’s commitment to strengthening Liberia’s public health infrastructure. He expressed pride in the dedication shown by his team, particularly the volunteers who support diagnostic efforts at the National Reference Lab around the clock. He also reassured the public that Liberia’s proactive measures, extensive disease surveillance, and local diagnostic advancements have made the country better prepared than ever to manage health crises effectively.
With Liberia on the path to self-sufficiency in its health sector, Dr. Nyan emphasized that the progress made by NPHIL reflects the nation’s resilience and its determination to provide for the health and safety of its citizens. As Liberia continues to build its capacity, he said, it serves as an example for other nations in the region on how commitment to public health can transform challenges into opportunities.
