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MPOX: Will it be Cataclysmic?

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MPOX: Will it be Cataclysmic?

(4 Minutes Read)

Vaccines are not the only solution. Preventive measures and creating awareness are crucial for arresting the spread of the virus. Africa has to develop a continental strategy to avoid recurrence with due international support. Let this be a wake-up call for global solidarity to combat the disease, unlike the COVID-19 pandemic.

Mpox, formerly known as Monkeypox, has been recurring in Africa for decades.  The first case was reported in Congo in 1970. It drew international attention in 2022 when it spread beyond Africa to the U.S., Europe, and Australia. But the recent spread of a new, more virulent, and transmissible strain -Clade 1b- within Africa and beyond has created global alarm. Taking cognisance of the virulent nature of the disease, WHO declared the Mpox outbreak as a public health emergency of international concern.

According to data from the Africa Centres for Disease Control and Prevention (Africa CDC), the Democratic Republic of Congo, the epicenter of the outbreak has reported 16,700 cases this year, with an estimated mortality of 3.6%. Most children under the age of fifteen have been afflicted. Initially, the cases were reported in five central African countries. Currently, more than 22,000 cases are reported from 14 African countries including East and West African nations. On August 14, the World Health Organisation (WHO) declared the outbreak, for the second time in two years, a ‘public health emergency of international concern (PHEIC), its highest level of international alert. Cases outside the continent include Sweden, Pakistan, and the Philippines.

Mpox can become fatal for children, pregnant women, and people with weak immune systems. The demographic structure and the fragile health infrastructure make the continent highly vulnerable. Health experts are worried that a failure to check the outbreak is a risk not only to Africa but the entire world.

To contain the disease, it is crucial to mobilize the necessary tools and Close surveillance. According to Africa Centres for Disease Control and Prevention, the continent needs at least 10 million doses of Mpox vaccines to arrest the epidemic. Yet, when it comes to accessibility to vaccines, Africa, despite being afflicted by the virus for decades, continues to face huge inequity. In 2022, WHO’s appeal for USD 34 million to fight Mpox got no response from donors. Africa had no access to the two shots used in the global outbreak, made by Bavarian Nordic and KM Biologics while these vaccines were available to 70 countries outside Africa.

The unavailability of the shots for Africa points out that global healthcare inequities from COVID-19, continue to reign. WHO and the Africa Centres for Disease Control and Prevention (CDC) have appealed to countries with stockpiles to donate doses. Spain, France, Germany, Japan, the US, and the EU have responded positively to the WHO request.

The hurdles are many more. The official process of WHO to give access to poor countries to large quantities of vaccines via international agencies continues to be complex, cumbersome, and time-consuming. Given the history of the virus in Africa, the process should have started years ago, say experts. The WHO asked vaccine manufacturers to submit applications for emergency licenses for Mpox vaccines and logistics only this month.

The two key Mpox shots, made by Denmark’s Bavarian Nordic and Japan’s KM Biologics, are expensive.  For example, Bavarian Nordic’s vaccine costs USD 100 a dose, which is beyond the reach of Africa. Given the long delay for WHO approval for international agencies to buy and distribute the vaccine, Africa has to depend on donations of shots.

DRC, the worst affected country is already grappling with conflict and multiple disease outbreaks. The weak administration, as per reports, is yet to make an official request to GAVI- the International Vaccine Alliance. The DRC government also took months to seek support from donor governments while its drug regulatory authority approved the two main vaccines only in June.

Other challenges for the DRC government are putting together a vaccination plan, meeting pre-shipment requirements, and ensuring proper storage and handling of the vaccines. These doses are to be preserved at -20C. How to administer the Vaccines is another huge issue. Almost 750000 people are living in camps after fleeing conflict. The widely used Bavarian Nordic Vaccine is meant for adults. The K M Biologic Vaccine can be given to children but is complex to administer.

Vaccines are not the only solution. Preventive measures and creating awareness are crucial for arresting the spread of the virus. Africa has to develop a continental strategy to avoid recurrence with due international support. Let this be a wake-up call for global solidarity to combat the disease, unlike the COVID-19 pandemic.