Alarmingly, the World Health Organization (WHO) declared mpox (formerly monkeypox) a public health emergency of international concern in August 2024 [1]. This decision was prompted by a surge in cases in the Democratic Republic of Congo and other parts of Africa, the potential for further spread within and beyond the continent, and the emergence of a new strain of the virus. WHO had previously declared mpox an emergency in July 2022, remaining until May 2023 when the situation had been considered under control.
The strategies recommended by WHO and other major institutions call for immediate financial contributions—up to 4 billion USD—to support pandemic prevention and control efforts, which include, among others, surveillance, risk communication, and immunization [2, 3]. While these measures—which can be viewed as downstream activities—are vital for preventing human-to-human transmission of mpox, it is equally important to address upstream activities.
Preventing outbreaks is typically more cost-effective than managing them. Therefore, attention must be given to the root causes of disease emergence, particularly where mpox is transmitted from animals to humans. Human interaction with bushmeat—any tissue from wild animals used as food—is a major factor in the spread of mpox in regions where animals carry the virus. A One Health approach offers a promising, cost-effective framework, promoting collaboration across sectors to address the connections between humans, bushmeat, and the environment [2].
Over the last 10 years (2014–2024), there have been 16 mpox spillover events linked to bushmeat, which is more than in previous decades (see Additional file 1 for an overview). Most of these cases occurred in Africa, except for four cases involving travelers from Nigeria to the UK (n = 2), Singapore (n = 1), and Israel (n = 1). Where gender and age data were available, children made up the majority of those affected (48%), followed by men (34%) and women (18%). Rats were the most reported type of bushmeat involved, followed by squirrels and monkeys. Most spillover events did not result in large-scale outbreaks, and both handling and consumption were commonly linked to these cases.
Reducing risky interactions with bushmeat could help prevent mpox and other foodborne diseases early on. Bushmeat is often sold alongside other fresh foods in informal or “wet” markets, meaning traditional, non-modern food sale points. Since these markets and bushmeat activities typically operate with minimal regulation and inconsistent hygiene, applying advances in practices and policies from food safety research in informal markets could help mitigate the risks posed by bushmeat.
Based on two decades of research by the CGIAR—a global research partnership dedicated to transforming food, land, and water systems in a climate crisis—and partners in these hard-to-reach markets [4], the “three-legged stool” approach was developed. This approach posits that food safety can be improved if, and only if, three areas are addressed: [1] building capacity of value chain actors through training and simple technologies, [2] motivating behavior change through incentives and nudges, and [3] improving policies and regulations. Each component is essential for adopting safer practices. We expand below on how this approach could apply to bushmeat.
