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Author: Moses Nyambalo Phiri

  • PHIM Enhances Chitipa and Karonga Preparedness and response capability for Cholera, Mpox, and Marburg.

    PHIM Enhances Chitipa and Karonga Preparedness and response capability for Cholera, Mpox, and Marburg.

    Cholera, Mpox, and Marburg Training.

    Chitipa, Malawi – March 7th, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Chriswell Nkoloma and Settie Kanyanda.

    In a proactive approach to enhance the country’s response to public health emergencies, the Public Health Institute of Malawi (PHIM), with support from AMREF, conducted crucial training sessions in  Karonga and Chitipa districts. These sessions focused on cholera, Mpox, and Marburg.

    These activities aim to ensure that healthcare workers can effectively manage cases, strengthen surveillance and contact tracing, improve laboratory diagnostics, and educate communities on preventive measures for Mpox, Marburg, and Cholera.

    From May 6th to 7th, 2025, Public Health Emergency Management Committees and District Rapid Response Teams in the two districts were refreshed on their roles and responsibilities. Subsequently, from May 8th to 14th, frontline healthcare workers, including clinicians, nurses, health surveillance assistants, laboratory staff, and data clerks, received specialized training on sample collection, clinical case management, data reporting etc.

    Mr. Chriwell Nkoloma presenting on Mpox Global Overview and Malawi Situation to the Chitipa DRRT.

    Hester Mkwinda Nyasulu, Amref Country Director – Malawi.
  • Mpox Situation in Malawi.

    Mpox Situation in Malawi.

    MPOX SITUATION.

    National Public Health Emergency Operations Centre (NPHEOC), Lilongwe, Malawi, 2025.
    by
    Moses Nyambalo Phiri in collaboration with Grace Funsani, Chriswell Nkoloma and Settie Kanyanda.

    Malawi has recorded two new laboratory-confirmed Mpox cases as of October 6, 2025, bringing the total number of cases in the country to 128 since the first case was recorded on April 17, 2025. These cases exclude two cross-border cases. The update comes from the Public Health Institute of Malawi (PHIM) in its Mpox Spot Report, Issue 62, published on October 6, 2025.

    Both new cases are young female children who reported to health facilities on September 30, 2025.
    An 11-year-old female child from Area 25, who reported at the Area 25 Health Facility and a 9-year-old female child from Chilinde 1, who reported at the Chilinde Health Facility.

    The patients presented with common symptoms, including fever, cough, and a skin rash, and reportedly had no underlying health conditions. Lesion swab samples were collected and sent to the laboratory on the same day they visited the facilities, and Mpox infection was confirmed through testing on September 30, 2025. Neither of the confirmed cases has a history of travel outside of Malawi.

    Mpox Outbreak Report – Malawi

    Malawi’s Coordinated Public Health Response

    The Public Health Institute of Malawi has implemented a multi-faceted strategy using a One-Health approach to contain the outbreak, protect public health, and provide care.

    🚨

    Activation

    Incident Management System (IMS) Activated

    🤝

    Collaboration

    Multi-sectoral One-Health Surveillance

    🏃

    Action

    Rapid Response Teams Deployed

    📚

    Engagement

    Risk Communication & Community Engagement

“The first case was recorded in Lilongwe district on April 16, 2025. Later additional cases were registered.  All the cases are males within the age range of 2 to 38 years: a 30-year-old from Phwetekere- Area 36, a 33-year-old from Kawale 2, 38 year-old from Chilinde, a 35 year-old from Area 36, Kandikole, an 18 year-old from Area 36, Tumbwe, Traditional Authority (TA) Tsabango, Lilongwe district, and a two year-old child from Michesi 1 village, TA Mponda, Mangochi district.Three cases from Lilongwe have recovered and have been discharged from clinical care, while the other three are still under clinical care . No death has been reported.”

Grace Fusani – Mpox Incident Manager, PHIM.
Mpox in Malawi: Outbreak Infographic

Total Confirmed Cases

141

(138 Domestic, 3 Cross-Border)

Total Deaths

1

(CFR ~0.7%)

Contacts Traced

1,412

(1,383 Discharged, 29 Follow-up)

Active Cases

0

(Zero (0) Domestic Cases Active)

Live Mpox Situation Dashboard

View the real-time epidemiological and response data directly from the national surveillance system in this interactive dashboard. (Scroll horizontally if necessary.)

Temporal Trend: Outbreak Progression (Interactive)

This chart shows the epidemic curve of confirmed cases over time. Monitoring this trend helps determine the effectiveness of containment strategies and predict future resource needs. (Scroll horizontally if necessary.)

Demographic Profile (Interactive)

This chart provides a breakdown of the case demographics. Current data shows that females account for 46% of cases and children represent a significant portion of the total case load, emphasizing the widespread transmission and the need for specialized pediatric and community-wide public health messaging. (Scroll horizontally if necessary.)

Geographical Distribution: Outbreak Epicenter & Spread (Interactive)

The outbreak has affected 12 districts, but Lilongwe remains the clear epicenter, accounting for over 80% of all confirmed domestic cases. This concentration guides the targeted public health and vaccination response. This map/chart provides a detailed view of the spread across the country. (Scroll horizontally if necessary.)

Age Distribution (Static)

Children represent a significant portion of cases, accounting for 25% of all infections. This necessitates specialized pediatric care and targeted IPC measures in schools.

Clinical Insights: High-Risk Links & Features

A preliminary audit of 34 inpatients from KCH and Lilongwe DHO provided critical insights. The findings revealed a high prevalence of severe disease and a significant correlation with HIV status, informing high-risk prioritization.

Clinical Manifestations Audit (Interactive)

This chart details the specific clinical features observed in the audited patient cohort. It highlights the frequency of severe symptoms like genital ulcers and bacterial superinfection, which informs case management protocols. (Scroll horizontally if necessary.)

The Critical HIV Correlation

HIV-positive patients were significantly more likely to develop severe complications. 10 of 12 (83%) HIV-positive patients had severe features, compared to only 5 of 12 (42%) HIV-negative patients.

Malawi’s Multi-Pillar National Response

Surveillance

Rigorous case finding and contact tracing protocols. District Rapid Response Teams (DRRTs) are trained and deployed to interrupt transmission chains.

  • 1,412 contacts traced to date
  • Active case search ongoing

Case Management

Development and dissemination of protocols for Home-Based Care (HBC) for mild cases, reserving ETUs for severe cases.

  • Zero (0) active domestic cases
  • 132 cases discharged from care

IPC & WASH

Focused on minimizing transmission in homes, communities, and health facilities. Preparing for safe school environments.

  • Home-based IPC package developed
  • IPC/WASH assessment ongoing

Vaccination

PMRA has approved the MVA-BN vaccine. Strategic allocation to high-risk groups has achieved significant coverage.

  • 80% of Target Population Vaccinated
  • Targeted vaccination for high-risk groups

Ongoing Challenges & Commitment

Non-Disclosure of Contacts

Non-disclosure of contacts by some clients remains a barrier to rapid containment, complicating tracing and follow-up efforts.

Incomplete Data Capturing

Incomplete data in registers and forms hinders retrospective analysis and makes tracing of potentially missed cases identified through active search challenging.

Movement of Suspected Cases

The movement of suspected cases before the release of laboratory results poses a risk and complicates isolation and immediate case management.

What response activities have so far been undertaken ?

Cases
Malawi Mpox Outbreak

PHIM has activated its Incident Management System (IMS) for Mpox and is working with various sectors, including animal health, civic education, and disaster management, using One Health Approach

Mpox Suspect in Lilongwe

1. Surveillance.

Rapid Response Teams (RRTs) have been deployed to conduct contact tracing and investigate cases. Surveillance systems have been enhanced at the community level, health facilities, and points of entry (PoEs).

The district team are being trained on Mpox through a collaborative effort involving Amref Health Africa, the US CDC, and the World Bank, which have provided the necessary resources. Initial training, supported by Amref Health Africa, has been conducted in the Chitipa and Karonga districts. This district level training will be extended to all districts to ensure comprehensive staff preparedness covering critical areas such as Mpox Etiology and Virology, Transmission Pathways, Prevention and Control Measures, and Clinical Management etc.

Chitipa -Mpox District Training 7/May/2025.

2. Case Management.

Case management guidelines have been developed and distributed, and isolation facilities have been identified.

3. Labolatory.

Samples from suspected cases are being tested using PCR, and genomic sequencing of the Mpox virus is underway.

Mpox sample testing in the national laboratory

Essential medicines and PPEs have been distributed to districts and Messages about Mpox prevention are being disseminated in local languages through various channels, including posters, social media, leaflets, and audio recordings. PHIM is working to address these challenges and will continue to provide updates on the situation.

  • The Public Health Institute of Malawi (PHIM) Attends the International Association of National Public Health Institutes (IANPHI) Annual Meeting.

    The Public Health Institute of Malawi (PHIM) Attends the International Association of National Public Health Institutes (IANPHI) Annual Meeting.

    IANPHI ANNUAL MEETING

    Maputo, Mozambique – April 9-10th, 2025..
    by
    Settie Kanyanda in collaboration with Moses Nyambalo Phiri..

    The IANPHI Annual Meeting was held from April 9 – 10 in Maputo, Mozambique and was hosted by the National Institute of Public Health (NIS) of Mozambique. The Annual Meeting was held under the Theme: “The role of National Public Health Institutes (NPHIs) in promoting healthy, equitable and resilient societies to tackle current and future threats”. The meeting was attended by over 200 attendees from different countries around the world, with fifty countries physically represented at the meeting while others joined the meeting virtually. Malawi was represented by a delegation from the Public Health Institute of Malawi (PHIM) led by Dr. Matthew Kagoli, Director of PHIM, and accompanied by Dr. Dzinkambani Kambalame from Research Division and Setiala Kanyanda, Technical Advisor to PHIM Director. Also joining the team from PHIM were Dr. Guri Rørtveit, the Director General of Norwegian Institute of Public Health (NIPH), Dr Trude Arnesen and Dr. Bjorn Iversen from the NIPH, and Katarina Dihm from GIZ, Malawi Country Office

    Several speakers at the meeting who included the Minister of Health of the Republic of Mozambique, H.E. Dr. Ussene Isse, the president of IANPHI, Prof. Duncan Selbie, the Director General of Africa CDC, Dr. Jean Kaseya, pointed out some global health threats like climate change and increased frequency of diseases as health threats which require multilateral corporations and use of scientific intelligence to address.

    Some of the challenges affecting Africa include an unprecedented health financing crisis and rising disease outbreaks such that there has been a 41% increase in disease outbreaks from 2022 to 2024. Other problems include vulnerability of health systems, less domestic resources, insecurity and humanitarian crisis. The problem of health financing is evident in that only six out of the 55 countries in Africa have a national health financing plan.

    The withdrawal of the USA from WHO has left a gap in financial power and has created a need for other countries or organizations like the European Union to come in and provide support to strengthen the WHO activities. Global economic crisis makes health suffer where women, children, and the elderly suffer most.

    That will therefore have negative consequences for global health. Public health financing is therefore key in addressing global health threats and such finances should be properly prioritized. To be successful, NPHIs should look for traditional funding through public – private health financing and regional financing to strengthen primary health care including community health surveillance. Public Health Institutes (PHIs) are therefore key in addressing these global health challenges and this highlights the need for every country to have its own PHI. Currently, IANPHI has a total of 128 member institutions from 107 countries including Malawi. Seven new members which are Siera Leon, Mali, Venezuela, Kenya, Uganda, Singapore and Northern Ireland were presented with certificates during the meeting.

    Before the establishment of NPHIs, outbreaks were being responded to by ad hoc committees and at the end of the outbreak, the committees were dissolved resulting in loss of institutional memory which is not the case with NPHIs. The NPHIs have proper and well-organized mechanisms for responding to disease outbreaks and other global health threats. The NPHIs are supposed to collaborate with each other so that they can become stronger together to be able to protect and improve the health of the people.

    One of the focus areas that IANPHI is also making efforts on is addressing the impacts of climate change which include flooding, heat, and wildfires. As a way of showing its commitment to dealing with effects of climate, IANPHI signed a Memorandum of Understanding (MoU) with the World Meteorological Office (WMO) in December 2024. Some NPHIs like Austria NPHI has already established a competence center on climate and health which bundles interdisciplinary expertise from research, policy and practice at the interface of mitigation, adaptation, health promotion and health systems.

    The Austria NPHI also developed a national heat action plan using the modular design based on WHO recommendations to assist in its response to extreme high weather conditions. Climate and health problems call for a need to advocate for strengthening capacity of NPHIs to contribute effectively to climate and biodiversity. NPHIs therefore need to collaborate with international and regional organizations in the field of climate change. Mayotte Island in the Indian Ocean suffered the effects of climate change when it experienced a lot of infrastructure damage from Cyclone Chido.

    This damage affected response activities since communication structures for data sharing were also down and this resulted in the use of paper-based data collection which caused delays in timely sharing of data. This therefore requires advocating for investment in resilient infrastructure and community training.

    Dr. Kagoli with the new Secretary General.

    During the meeting, the new IANPHI Secretary General Prof. Neil Squires was unveiled. It is interesting to note that he once worked in Malawi as a District Medical Officer at Dowa District Hospital in the 1990s. In his speech, he quoted a Malawian proverb Mutu umodzi Susenza denga in trying to mention that not one NPHI will be able to carry the IANPHI to greater heights. This means all NPHIs are responsible for the success of IANPHI.

    It was interesting to note that IANPHI presented certificates of recognition of success to one IANPHI member per IANPHI Regional Network for the outstanding research projects they did. This serves as motivation to do more and to do better. The certificates were given to Finish Institute for Health and Welfare in Europe, Mexico NPHI in Latin America, National Institute of Health of Mozambique in Africa and Korea Disease Control and Prevention Agency in Asia.

    During the meeting, a declaration was developed which will be called “Maputo Declaration” which aims at making a call to action to address public health issues. This declaration will be a strong tool in strengthening Public Health and Public Health Institutes.

    A visit to the National Institute of Health of Mozambique, revealed how far the institute has come from. It started as a Medical Research Institute of Mozambique in 1955 and has over the years changed names and its responsibilities until in 2017 when it was re-defined as a Public Health Institute. It currently has offices in all the provinces of Mozambique which are headed by a director.

    These provincial offices also have provincial laboratories where clinical laboratories transport the samples to the provincial laboratories and if need be, the provincial laboratories transport the samples to the Reference Laboratories.  One of the key areas of focus for the INS is research whereby in 2024 alone, a total of 80 publications were made and it currently has 65 research projects underway. This is made possible through its collaborations with both local and international research institutions.

    Dr. Zinkambani Kambalame, Head of National Public Health Research Science -PHIM, giving a presentation.

    In Malawi, the partner for this project is GIZ. During the meeting, Dr. Dzinkambani Kambalame made a presentation on Malawi specific activities. The project is expected to commence in 2025

    Team Europe organized a side meeting for a project it is carrying out to support and strengthen selected10 African National Public Health Institutes which include PHIM. The project areas include networking and collaborating with other PHIs, gender transformative research, development of policy advice for policy change, digital literacy, and Sexual and Reproductive Health Rights (SRHR) surveillance framework.