MONROVIA – On November 14, 2024, Dr. Dougbeh Chris Nyan, Director-General of the National Public Health Institute of Liberia (NPHIL), addressed the public during a comprehensive press briefing at NPHIL’s headquarters in Congo Town, Monrovia. Dr. Nyan discussed Liberia’s progress in managing the ongoing outbreak of monkeypox (MPOX) and elaborated on the country’s improved disease detection and response mechanisms. His update offered insights into public health challenges, collaborative efforts, and the institute’s reliance on innovation and resilience to protect Liberians.
Dr. Nyan began by providing an overview of Liberia’s MPOX statistics. He noted that prior to the official outbreak announcement, six cases were registered. Since the announcement, an additional 14 cases have been documented, bringing the total to 20. The public health chief highlighted the significance of Liberia recording zero fatalities, which he attributed to the strength of the nation’s case management system. He explained that the successful containment reflects the quality of clinical care, infectious disease control measures, and early detection strategies implemented across the country.
Acknowledging the critical role of awareness and community engagement, Dr. Nyan emphasized how early and accurate interventions can mitigate public health risks. He pointed out that increased awareness has led to a greater capacity for identifying and managing cases. Liberia’s diagnostic capabilities, bolstered by recent acquisitions in sequencing technology, have also played a pivotal role in combating MPOX.
Dr. Nyan elaborated on the difficulties of delivering healthcare services to remote regions, using Sinoe and Lofa Counties as examples. He described the challenging terrain, which often requires a mix of vehicles, motorcycles, and rafts to reach patients. In such conditions, healthcare workers have had to devise innovative, non-traditional methods of isolating and treating infected individuals. These efforts underscore the adaptability and dedication of Liberia’s public health teams, who often work under less-than-ideal circumstances.
A major component of NPHIL’s efforts is the One Health platform, which integrates human, animal, and environmental health strategies. Dr. Nyan noted that since assuming leadership in August, NPHIL has activated and strengthened the platform’s various pillars. This includes collaboration with the Ministry of Agriculture to investigate zoonotic diseases and analyze transmission patterns. These activities, he stressed, are crucial for addressing Liberia’s complex public health landscape.
Dr. Nyan also shed light on the genetic makeup of MPOX and its various clades. He explained that clades 1A and 1B are prevalent in East and Central Africa, while clades 2A and 2B circulate in West Africa. The differences in transmissibility and geographic distribution of these clades underscore the importance of regional cooperation and research. Notably, he projected the possibility of identifying a new clade in the future, emphasizing the need for vigilance and scientific collaboration to prevent mutations that could evade current diagnostics and treatments.
Addressing the funding constraints, Dr. Nyan revealed that while the Liberian government had allocated $380,000 for public health initiatives in the 2024 national budget, these funds have yet to be disbursed. NPHIL has relied on external support from partners such as the U.S. Centers for Disease Control and Prevention (CDC), USAID, the World Health Organization (WHO), and Africa CDC to sustain its operations. These partners have provided equipment, diagnostic reagents, and other essential resources, enabling Liberia to maintain its public health response.
Dr. Nyan expressed gratitude to NPHIL’s workforce, many of whom continue to serve without financial compensation. He emphasized the need for greater investment in public health and announced plans to petition the Liberian legislature for increased funding. He also highlighted the importance of securing molecular and serological diagnostic equipment to enhance Liberia’s diagnostic capacity further.
In addition to MPOX, Dr. Nyan revealed that co-infections with other viruses, such as varicella zoster virus (VZV) and Epstein-Barr virus (EBV), have been detected in MPOX patients. These findings underscore the complexity of Liberia’s public health challenges and the need for comprehensive diagnostic approaches, such as metagenomic analysis, to identify co-circulating pathogens.
Dr. Nyan emphasized the significance of public awareness campaigns in curbing the spread of MPOX. NPHIL, with support from UNICEF and WHO, has distributed educational materials across the country and launched radio and television programs in various local languages. These efforts aim to inform communities about the symptoms, transmission, and prevention of MPOX, including avoiding contact with symptomatic individuals and seeking immediate medical attention if symptoms appear.
He stressed the importance of identifying MPOX’s characteristic symptoms, such as cold-like signs, fever, and the appearance of bumps on the skin and palms. Early detection, he reiterated, is crucial for preventing further transmission and ensuring effective treatment.
Dr. Nyan also touched on the challenges of addressing simultaneous public health threats, including ongoing outbreaks of measles and Lassa fever. He called for a holistic approach to disease management, emphasizing the need to integrate these efforts into Liberia’s broader public health strategy.
He shared that NPHIL has been collaborating with regional and international partners to learn from best practices and enhance Liberia’s response capabilities. These partnerships have been instrumental in securing vital resources and fostering knowledge exchange, which have significantly strengthened Liberia’s public health infrastructure.
Reflecting on Liberia’s achievements in containing MPOX, Dr. Nyan praised the dedication of healthcare workers, researchers, and public health officials. He underscored the importance of innovation, adaptability, and collaboration in overcoming challenges and ensuring the safety of all Liberians.
He also addressed the global implications of Liberia’s public health efforts. The lessons learned from navigating complex terrains and managing limited resources can serve as a model for other nations facing similar challenges.
Dr. Nyan reaffirmed NPHIL’s commitment to transparency, scientific rigor, and community engagement. He invited feedback from the media and the public, emphasizing the importance of constructive criticism in improving public health outcomes.
In closing, Dr. Nyan reiterated the need for sustained support from both the Liberian government and international partners. He called for increased investment in public health, emphasizing that the safety and well-being of Liberians depend on a robust and well-funded healthcare system.
As Liberia continues to confront public health challenges, NPHIL remains at the forefront of efforts to protect and promote the health of its citizens. Dr. Nyan’s briefing served as a powerful reminder of the resilience and determination that define Liberia’s public health response.
