Urgent Response Needed: Mpox Vaccine Delays in Africa Highlight Global Health Inequities

Introduction

The mpox outbreak in Africa has become a stark reminder of the persistent global health disparities affecting lower-income nations. Despite significant promises from wealthier countries to provide vaccines, African nations are still waiting for the much-needed doses. This delay has intensified the health crisis, revealing deep-rooted issues in global health equity and international aid. As the outbreak worsens, the need for a swift and effective response has never been more critical.

The Mpox Outbreak: Current Status and Impact

The Democratic Republic of the Congo (DRC) is at the heart of a severe mpox outbreak caused by the new clade 1b variant. As of early September 2024, the DRC has reported approximately 18,000 suspected cases and 629 deaths. This new variant, identified for the first time in early 2024, has a higher transmission rate compared to previous strains, significantly affecting both urban and rural areas.

Spread of the Variant

This clade 1b variant has not been confined to the DRC alone. It has been detected in neighboring countries including Burundi, Uganda, Rwanda, Kenya, as well as in Sweden and Thailand. The global spread of this variant underscores the urgent need for a coordinated international response to prevent further dissemination.

Delayed Vaccine Rollout: The Broken Promises

The international community had pledged significant support to combat the mpox outbreak. Spain committed 500,000 doses, France and Germany each promised 100,000 doses, and the United States pledged 50,000 doses. Despite these assurances, none of these doses have been delivered to the affected countries. This delay not only hampers immediate containment efforts but also undermines trust in global health commitments.

The Role of WHO and Africa CDC

The World Health Organization (WHO) had assured that vaccines would arrive in the DRC “within days” after the outbreak was declared a public health emergency in mid-August 2024. However, these assurances have yet to result in tangible support. The Africa Centres for Disease Control and Prevention (Africa CDC) has reported that its request for $245 million to address the outbreak remains only 10% funded. This lack of financial support highlights the challenges faced by African health organizations in managing and mitigating the crisis.

Expert Opinions on the Vaccine Delays

Dr. Dimie Ogoina, an infectious disease specialist at the Niger Delta University Teaching Hospital, has expressed frustration with both international and African responses to the outbreak. He points out that, despite mpox being first identified in the DRC in 1970, significant progress in vaccine development and availability has been lacking. The global focus on mpox only intensified when the virus spread to Europe and North America in 2022, highlighting a disparity in international health priorities.

Peter Maybarduk, Director of Public Citizen’s Access-to-Medicines program, has criticized the high prices of the Bavarian Nordic-produced Jynneos vaccine. He attributes the delays and high costs to systemic issues of greed and inequity within the global health system.

Victorine de Milliano, policy adviser at Médecins Sans Frontières (MSF) Access, has highlighted the recurring issue of lower-income countries struggling to access essential medical tools. She drew parallels between the current situation and the Covid-19 pandemic, where wealthier nations were able to stockpile vaccines and treatments, leaving poorer countries at a disadvantage.

Pharmaceutical Companies Response

Bavarian Nordic, the manufacturer of the Jynneos vaccine, has stated that it is prepared to provide 2 million doses if it receives approval for orders. The company has already donated 55,000 doses and is open to implementing tiered pricing strategies to make vaccines more affordable for lower-income countries. However, the effectiveness of these measures depends on prompt and coordinated distribution efforts.

Recent Developments and Updates

As of early September 2024, the situation remains critical with rising case numbers and continued delays in vaccine distribution. The WHO has reiterated the urgency of the situation, emphasizing the need for immediate action to control the outbreak and prevent further loss of life.

Timeline of Key Events

• August 2024: WHO declares a public health emergency due to the new clade 1b variant of mpox.
• Early September 2024: Initial vaccine rollout in Africa is delayed; vaccines promised by Spain, France, Germany, and the US have not yet been delivered.
• July 2024: International pledges for mpox vaccine donations are announced.
• June 2024: Africa CDC reports a 10% funding rate for its $245 million request to tackle the outbreak.

Conclusion

The ongoing delays in vaccine delivery for the mpox outbreak in Africa underscore a severe global health inequity. Despite numerous promises from international donors, the affected regions continue to suffer due to unmet commitments and inefficient responses. To effectively address this crisis, it is crucial for both global and local stakeholders to ensure that promises are fulfilled and that long-term solutions are implemented to prevent similar situations in the future.

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FAQs:

1. What is the current status of the mpox outbreak in Africa?
   • The Democratic Republic of the Congo (DRC) is experiencing a severe outbreak of the new clade 1b variant of mpox, with approximately 18,000 suspected cases and 629 deaths reported in 2024. The outbreak has also spread to several other African countries and beyond.
2. Why are there delays in the mpox vaccine rollout?
   • Delays are due to unfulfilled vaccine donations from several countries, including Spain, France, Germany, and the United States. The promised doses have yet to be delivered, hindering efforts to control the outbreak.
3. What is the Africa CDC’s role in addressing the mpox outbreak?
   • The Africa CDC coordinates the response to the mpox outbreak, including managing funding requests and vaccine distribution. However, it has received only 10% of the $245 million it requested, complicating its efforts to manage the crisis.
4. How has the international community responded to the mpox crisis?
   • The response has been criticized for delays and inefficiencies. Promises of vaccine donations have not been met, highlighting issues of inequity and lack of effective international coordination.
5. What are the potential solutions to the vaccine access issue?
   • Solutions include increasing financial and logistical support for timely vaccine delivery, implementing tiered pricing strategies by manufacturers, and strengthening local health systems to reduce reliance on international donations.