For one thing, much poorer health reporting systems.
Or maybe western MSM not giving a lot of coverage to goings-on in Africa. However,
https://en.wikipedia.org/wiki/Monkeypox#2017%E2%80%932019_Nigeria_outbreak :
Monkeypox has been reportedly spread around southeast and south Nigeria. Some states and the federal government of Nigeria are currently seeking a way to contain it, as well as find a cure for the infected ones. It has spread to Akwa Ibom, Abia, Bayelsa, Benue, Cross River, Delta, Edo, Ekiti, Enugu, Imo, Lagos, Nasarawa, Oyo, Plateau, Rivers and Federal Capital Territory. The outbreak started in September 2017 and remained ongoing across multiple states as of May 2019.
Confirmed cases of Monkeypox by state in Nigeria
According to information provided by the Nigeria Centre for Disease Control, between 1971 and 1978, 10 human Monkeypox infections were reported in the country. In September 2017, human monkeypox re-emerged in Nigeria, after 39 years when it was last reported. The 2017 human monkeypox outbreak in the country was large. Bayelsa state was the first state in Nigeria to have reported the 2017 outbreak. The CDC has reported cases of American travelers contracting Monkeypox upon return from Lagos and Ibadan. Agam Rao, a medical officer in the Division of Pathogens and High Consequence Pathology at the Centers for Disease Control and Prevention, said that since 2018 all cases reported outside Africa have come from Nigeria.
As British health authorities reported the first case of Monkeypox in the UK in May 2022, the Nigerian government has released to the public information and statistics on reported cases and deaths in the country. In a report released on May 9, 2022, the NCDC states that 230 cases were confirmed across 20 states and the Federal Capital Territory between 2017 and 2022. In 2022, NCDC has implemented National Technical Working Group, abbreviated as NTWG, for the purpose of reporting and monitoring infections, in addition to strengthening response capacity. In the NCDC report, Rivers State was the most affected by Monkeypox followed by Bayelsa and Lagos. In the span from 2017 to 2022, the NCDC reported 6 deaths in 6 different states, making for a 3.3% Case Fatality Ratio. In an article published by The Conversation, Oyewale Tomori pointed out that the number of Monkeypox infections in Nigeria through 2021 is likely to be under-represented, because much of the Nigerian population has been avoiding healthcare facilities due to fear of contracting COVID-19.
There's no shortage of monkeypox in Africa, just a "shortage" of MSM coverage (not that I blame them).
