GENEVA: The first 10,000 mpox vaccines are finally set to arrive in Africa next week, marking a significant but delayed intervention against a virus that has been a persistent threat on the continent.
The slow arrival of these vaccines, which have been available in over 70 countries outside Africa for some time, has underscored enduring global health inequities, according to public health experts and officials.
Mpox, a potentially severe infection characterized by flu-like symptoms and pus-filled lesions, has long been endemic in Africa, with a new, more virulent strain known as clade Ib causing increased concern.
The World Health Organization (WHO) declared mpox a global health emergency on August 14, after the new strain began spreading from the Democratic Republic of Congo (DRC) to neighboring countries.
The delay in vaccine availability highlights a troubling pattern seen during the COVID-19 pandemic, where low-income countries often faced delays and difficulties accessing crucial health resources. According to public health officials, the process for securing and distributing vaccines to poorer nations should have been initiated years ago but only began recently.
The WHO’s slow approval process for mpox vaccines, which are crucial for managing the outbreak, has been a major hurdle. Although the WHO recently started the process to enable international agencies to purchase and distribute vaccines, this could have been initiated much earlier, according to several experts. The delay has meant that African countries, struggling with limited resources, have had to rely on donations from wealthier nations rather than purchasing vaccines directly.
The vaccines, produced by Denmark’s Bavarian Nordic and Japan’s KM Biologics, are expensive and out of reach for many low-income countries. Bavarian Nordic’s vaccine costs approximately $100 per dose, while KM Biologics’ price remains undisclosed.
With the approval and procurement process dragging on, individual African governments and the Africa Centres for Disease Control and Prevention (CDC) have had to seek donations from richer countries to secure the vaccines.
The initial batch of 10,000 vaccines, provided by the United States, will be sent to Nigeria rather than Congo, despite the latter being the hardest hit. Nigeria has reported 786 suspected cases this year but no deaths. The US Agency for International Development (USAID) has also pledged 50,000 doses to Congo, although the delivery date remains uncertain.
Helen Rees, a member of the Africa CDC’s mpox emergency committee and executive director of the Wits RHI Research Institute in Johannesburg, criticized the delay as “really outrageous.” She highlighted that Africa’s struggle with vaccine access during the COVID-19 pandemic has repeated itself with mpox.
During the COVID-19 pandemic, vaccines were quickly repurposed and distributed to high- and middle-income countries, reaching 1.2 million people in the United States alone. However, African countries have had to rely on clinical trials and donations to access these vaccines, which underscores a persistent disparity in global health resource distribution.
The WHO has been criticized for its slow response and complex approval processes, which have impeded timely vaccine deployment. The organization has only recently begun asking vaccine manufacturers to submit the necessary data for emergency licensing and has urged countries to donate vaccines while the approval process is finalized.
The Africa CDC estimates that up to 10 million doses may be needed across the continent. Despite the WHO’s recent efforts to expedite vaccine distribution, questions remain about how to effectively use the vaccines. For instance, Bavarian Nordic’s vaccine is currently only approved for adults, while the KM Biologics vaccine, which can be administered to children, is more complex to use.
In addition to vaccine distribution challenges, public health experts stress the need for broader measures to control mpox. Jean Jacques Muyembe, co-discoverer of the Ebola virus, emphasized the importance of awareness, diagnosis, and other public health strategies alongside vaccination efforts.
Ayoade Alakija, co-chair of a global health partnership, pointed out that the slow focus on diseases affecting predominantly black and brown populations reflects a broader issue of global health equity.
