Uganda’s Mpox Response Focuses on Innovation, Inclusivity, and Key Populations' Empowerment

WHO Partners with MARPI Clinic to Combat Stigma and Enhance Healthcare Access for Vulnerable Groups.

Uganda is tackling its ongoing mpox outbreak with a comprehensive, inclusive approach that prioritizes Key Populations (KPs) such as sex workers, often marginalized and at higher risk of infection due to stigma, discrimination, and limited healthcare access. Recognizing the need for targeted, community-driven responses, the World Health Organization (WHO) has partnered with the Most At Risk Populations Initiative (MARPI) Clinic Mulago to enhance surveillance, diagnosis, and patient care within these vulnerable groups.

Mpox cases have emerged in Uganda's hotspots, highlighting the urgency of reaching KPs, particularly sex workers who face systemic barriers to healthcare. For individuals like Tracy, a sex worker in Kawempe, the outbreak caused immediate fear and uncertainty. “I didn’t know if it was something serious, and I was afraid of being stigmatized,” Tracy recalls. However, the support from MARPI Clinic's trained staff provided Tracy with both medical attention and reassurance. “They acted quickly, made me feel safe, and ensured I wasn’t alone.”

Stigma, compounded by deep-seated distrust of healthcare systems, prevents many KPs from seeking timely care. These populations, often marginalized, face a vicious cycle of discrimination, mobility, and fear of judgment that complicates access to life-saving medical services. Dr. Jerome Ntege, WHO anthropologist, explains: “Without collaboration, many cases would go undetected.”

A Strategic Collaboration: Empowering Communities to Fight Mpox

WHO’s partnership with MARPI Clinic is a model of community engagement and education. With MARPI's established relationship with KPs, WHO has implemented a targeted initiative to increase mpox surveillance and response within at-risk communities. The partnership includes:

• Training 40 MARPI staff on surveillance, diagnosis, and patient care.
• Equipping 40 civil society organizations managers to mobilize resources and engage their networks.
• Educating 150 community peers—sex workers and other KPs—on how to spot symptoms, report cases, and provide support.

This initiative has already made a tangible impact. Community leaders like Kyomugisha Ruth have become trusted sources of information, guiding others to care. Ruth shares, “During the training, we learned how to spot symptoms early and respond immediately. This knowledge has saved lives.” Ruth’s use of WhatsApp posters led to timely identification and treatment for several suspected cases.

Real-Life Impact: Saving Lives Through Peer Support

Personal stories underscore the success of this approach. Ruth recounts, “I shared a poster about mpox symptoms on my WhatsApp, and someone in my community reached out to me. I connected them with MARPI, and they got help. It feels amazing to know I played a part in saving someone’s life.”

A bar attendant from Rubaga also shares a similar story of trust and care: “I thought I was alone in this, but MARPI found me, took care of me, and ensured I got treatment. The doctors and peers treated me like a person, not just a case. That made all the difference.”

MARPI Clinic’s peer-based model remains a key driver of success in reaching vulnerable KPs, including those living with HIV and workers in informal sectors like bars. By fostering trust within peer networks, MARPI and WHO have overcome traditional barriers to healthcare, offering vital services to those who might have otherwise stayed away due to fear of judgment.

Long-Term Vision: Sustainable Public Health Responses

The collaboration between WHO and MARPI Clinic is expected to continue for several months, with the partnership acting as a sustainable model for inclusive healthcare in Uganda. Dr. Joseph Wamala, WHO Incident Manager for the mpox response, notes: “This collaboration has shown that by working together, we can reach even the most marginalized groups and make a real impact.”

This approach not only addresses immediate healthcare needs but also builds lasting relationships with KPs, equipping them with knowledge, resources, and empowerment to better protect themselves and their communities in future public health emergencies. The initiative is a testament to the power of community-driven responses and the importance of inclusive healthcare in addressing health crises.