Despite the thousands of mpox doses promised to Africa, no vaccines have yet been delivered to any of the countries affected by the outbreak of a new variant, with a roll-out that had been planned for last week now pushed back.
The Democratic Republic of the Congo (DRC) has been at the centre of the outbreak of the new clade 1b variant, with 18 000 suspected cases and 629 deaths this year, and infections also being detected in Burundi, Uganda, Rwanda, Kenya, and now Sweden and Thailand.
WHO chief Tedros Adhanom Ghebreyesus said last Friday that the first doses should arrive in the DRC “within days” but similar statements were recently made regarding donated shots from the US, which have also not materialised on time.
There has been no co-ordinated response, with Spain pledging as many as 500 000 doses while France and Germany have promised 100 000 each and the US said it would donate 50 000.
The Guardian reports that none of the pledged vaccines has arrived.
The Africa Centres for Disease Control and Prevention (Africa CDC) said last Wednesday that the $245m it had requested to tackle the outbreak was only 10% funded.
Still reliant on others
Despite mpox being first identified in humans in the DRC in 1970, African nations vulnerable to its spread are reliant on donations of vaccines from the stockpiles of richer nations.
Dr Dimie Ogoina, an infectious disease physician at the Niger Delta University teaching hospital, said neglect both internationally and by African governments meant that, decades after mpox was first identified, there were still not enough vaccines or even treatments available to the affected countries.
He said it was only during the global outbreak in 2022, which saw the virus spread to Europe and North America, that there was a wider international reaction to the disease.
Ogoina said it was important for African countries themselves to invest in protecting against diseases like mpox to ensure they are not reliant on donors.
“The manufacturers are not based in Africa,” he said. “They tend to favour, knowingly or unknowingly, the global north. So if there’s a list of people to procure, Africa is always last on the list, and we are always the last to get supplies.”
The WHO declared a public health emergency in mid-August in response to the spread of clade 1b, the recently identified variant that spreads through close physical contact, including sexual contact but also within households.
Concern has been raised about high numbers of children dying, with a mortality rate of up to 8% for under-15s, according to the WHO. The latest update from Africa CDC showed a sharp rise in cases of almost 4 000, compared with 1 200 the previous week.
Last week, civil society groups published a letter to Gavi, the global vaccine alliance, urging it to push for lower pricing of the vaccine produced by pharmaceutical company Bavarian Nordic, and which currently costs between $50 and $75 a dose.
“The continuously unfolding injustice of mpox owes to long indifference and inequity, stigma, slowness, anaemic use of public power and yes, greed,” said Peter Maybarduk, access-to-medicines director at US-based campaign group Public Citizen, which signed the letter.
He said that while the US Government had invested in the development of the Jynneos vaccine used against mpox, the production and “outrageously high” prices were now being controlled by Bavarian Nordic.
Bavarian Nordic has told Africa CDC that it can provide 2m doses this year if it gets approval for orders, allowing it to reallocate resources from other production lines.
A spokesperson for the company told The Guardian it had donated 55 000 doses and would provide an update when an agreement was made to start delivering more widely.
The company also said it was open to using tiered pricing so that countries with smaller economies would be charged less as well as those who were able to order more vaccines and over longer periods of time.
Ogoina said there were promising signs of political leaders in Africa showing vigilance in response to the public health emergency and discussing how they can invest in tackling it, as well as pledges of support from outside the continent, but it would have to be sustained.
“(There have been) a lot of commitments, promises, but what happens after three months? Six months? What happens after one year? Will people still be interested?” he asked.
See more from MedicalBrief archives:
Germany, Japan, offer Africa mpox vaccine doses
Urgent global action needed stop Mpox pandemic
Africa fears monkeypox vaccine side-lining as disease spreads
First batch of donated mpox vaccines heads to Africa
Déjà vu global response to mpox