The first donation of mpox vaccines has arrived Democratic Republic of the Congo on Thursday, but officials say millions more doses will be needed.
The announcement came amid warnings that the geographic spread of the virus, formerly known as monkeypox, was increasing, and swift action was needed across the continent to contain the outbreak.
Almost 100,000 doses of Bavarian Nordic’s vaccine were delivered to the DRC’s capitalKinshasa, as part of a donation program from the European Union, with another 100,000 expected on Saturday.
Dr Jean Kaseya, Director General of the Regional Health Authority, Africa Centers for Disease Control and Prevention (Africa CDC), emphasized the need to combat the spread of the disease to neighboring countries.
“The outbreak is really touching [fast],” Kaseya said. “We really need to stop this quickly.”
Nearly 25,000 cases of mpox have been reported across Africa this year, with 5,549 confirmed by testing and 643 deaths, according to Africa CDC. Cases are up 104% compared to last year.
The DRC still accounts for most cases, but Kaseya said the numbers are rising elsewhere. He said he was “really concerned” about a reported case of mpox in a seven-year-old child in Guinea, which may be the first case of the new clade Ib variant located in West Africa. Sequence testing is still ongoing.
Clade Ib is a mutated form of the virus, newly detected in eastern DRCwhich appears to be spread through close contact between people and is driving the huge jump in case numbers.
The outbreak, which has spread to nearby countries, is declared a public health emergency by both the World Health Organization (WHO) and African health officials. A response plan is estimated to require nearly $600m (£455m) over the next six months, officials said.
About 380,000 doses of mpox vaccines have been pledged by Western partners, including the EU and the US, according to Africa CDC. However, they said 3 million doses would be needed to end outbreaks of the virus in the country.
Vaccination programs are expected to focus on contacts of suspected cases as well as health care and frontline workers in areas of active transmission.
However, the program is unlikely to get underway until October at the earliest, with local healthcare and logistics workers still being trained on how to store and administer the vaccine. A major public information campaign is also being launched to improve awareness of mpox and tackle vaccine hesitancy.
Most cases in the DRC are among children. Regulators are assessing information submitted by Bavarian Nordic, which could approve the vaccine for 12- to 17-year-olds by the end of the month, but approval for younger children will take longer.
There are concerns about the affordability of vaccines for a wider programme, with the WHO opposing the cost $50 to $75 per dose.
“Most vaccines cost around £1 or less,” said Dr Andrew Hill, from Liverpool University. “If there are large orders for millions of vaccine doses for Africa, Bavarian Nordic should lower their prices. Otherwise, they should allow a generic company to mass produce their vaccine at a low price.”
A spokesperson for Bavarian Nordic said: “While we are proud that our mpox vaccine has arrived to help people in Africa, it remains a concern for Bavarian Nordic that artificial prices are being mentioned, as there is no published dose price range. And we have not started to discuss prices with relevant organizations.”
The company previously suggested it would be open to a tiered pricing modelin which countries with fewer resources or those able to place larger, long-term orders paid less.
Within the NGK, clade Ib reported for the first time in Kinshasa this week. In a case report about one patient, Dr Eddy Lusamaki, of the DRC’s National Institute for Biomedical Research, wrote that it suggested the variant was spreading across the country.
Lusamaki said: “Its presence in Kinshasa, the capital, with several international connections by air traffic and multiple exchanges with Brazzaville in the Republic of Congo, illustrated the need for improved surveillance strategies to control the spread of the disease.”
Cases of the clade Ib variant have also been reported in Thailand and Sweden last month.
