None of the African countries affected by the outbreak of a new variant of mpox received any of the promised vaccine, pushing back a rollout planned for last week.
The Democratic Republic of the Congo (DRC) has been at the center of an outbreak of the new clade 1b variant, with 18,000 suspected cases and 629 deaths this year, according to the World Health Organization (WHO).
The variant has also been found in Burundi, Uganda, Rwanda, Kenya, Sweden and Thailand.
WHO chief Tedros Adhanom Ghebreyesus said on Friday that the first doses should arrive in the DRC “within days”, but similar statements have been made recently about donated shots from the USA, which did not materialize in time.
There was no coordinated response, with Spain pledging as many as 500,000 doses, while France and Germany pledged 100,000 each and the US said it would donate 50,000. None of the promises have been delivered so far.
The Africa Centers for Disease Control and Prevention (Africa CDC) said on Wednesday that the $245m (£187m) it requested to tackle the outbreak was only 10% funded.
Although mpox was first identified in the DRC in 1970, African countries vulnerable to its spread depend on donations of vaccines from the stockpiles of wealthier nations.
Dr Dimie Ogoina, an infectious disease doctor 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. for the affected countries.
He said it was just during the global outbreak in 2022which saw the virus spread to Europe and North America, that there was a wider international response to the disease.
Ogoina said it is important for African countries themselves to invest in protection against diseases such as mpox to ensure they are not dependent on donors.
“The manufacturers are not based in Africa,” he said. “They tend to favor, knowingly or unknowingly, the global north. So if there is a list of people to get, Africa is always last on the list, and we are always the last to get supplies.”
The The WHO has declared a public health emergency mid-August in response to the spread of clade 1b, a recently identified variant that spreads through close physical contact, including sexual contact, but also within households.
Concerns have been raised about the high number of children dying, with a death rate of up to 8% for under-15s, According to the WHO. The latest update from Africa CDC on Tuesday showed a sharp rise in cases of almost 4,000, compared to 1,200 the previous week.
Last week, civil society groups published a letter to Gavi, the global vaccine alliance, prompting it to push for lower prices of the vaccine produced by pharmaceutical company Bavarian Nordic, which currently costs between $50 and $75 per dose.
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“The ever-unfolding injustice of mpox is due to long indifference and inequality, stigma, inertia, anemic use of public power and yes, greed,” said Peter Maybarduk, director of access to medicine at US campaign group Public Citizen, who 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 controlled by Bavarian Nordic.
Victorine de Milliano, policy adviser at Médecins Sans Frontières’ wing for a campaign for equitable medical treatment, MSF Access, said there is a “systematic issue” that means low-income countries struggle to access medical supplies in public health emergencies, which was highlighted during the Covid pandemic, when wealthier countries were able to set up vaccines, tests and treatments.
“It’s a real sense of deja vu. You would have thought that we would learn some lessons from the Covid-19 pandemic, but we are seeing the same patterns again,” she said. “Low- and middle-income countries are also now dependent on those donations from high-income countries that do have access to the vaccines. And we also see a vaccine monopoly, [where they are] sold to the highest bidder.”
Bavarian Nordic told Africa CDC that it could supply 2 million doses this year if it gets approval for orders, allowing it to reallocate resources from other production lines.
A spokesman for the company told the Guardian it had donated 55,000 doses and would provide an update when an agreement was reached to start supplying 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 that were able to order more vaccines and over longer periods.
Ogoina said there are promising signs of political leaders in Africa being vigilant in responding to the public health emergency and discussing how they can invest to tackle it, as well as pledges of support from outside the continent, but this will need to be sustained.
“[There have been] many commitments, statements, promises, but what happens after three months? What happens after six months? What happens after one year? Will people still be interested, or will they lose interest?” he asked.
