Aafter two years of post-Covid talks, member states of the World Health Organization (WHO) fail this summer to agree plans for a more equitable distribution of vaccines to developing countries. Ensuring that life-saving doses are available to countries that need them most, rather than simply to those with the deepest pockets, is not just a moral imperative. This is in the self-interest of each nation, given the propensity of viruses to mutate and migrate. But achieving this requires big money and big concessions from pharmaceutical firms. And so, dishearteningly, the negotiations continue.
Perhaps the warnings about a new, more serious strain of mpox in Africa will finally end concentrate thoughts. Last week the WHO declare the current outbreak of the virus “a public health emergency of international concern”. Highly contagious, mpox can be spread by skin-to-skin contact, sharing contaminated material and contact with animals. the new “coat 1” variant appears to have a significantly higher mortality rate of approximately 4%. Cases have now been detected in 13 African countries, the overwhelming majority in the Democratic Republic of the Congo (DRC). More than 500 people have died so far.
The first recorded infection outside Africa, in Sweden, led the British health safety agency update his guidance to doctors in connection with the new tribe. Production of a vaccine, based on that developed to eradicate smallpox, is meanwhile underway scaled up by the Danish biotech firm Bavarian Nordic. The company’s share price rose dramatically over the past week as new orders came in.
Countries not yet affected are of course right to be concerned. But while governments emerge in the global north resources, mpox is allowed to spread almost unhindered in its regional epicenter. A disaster combination of domestic regulatory delays, a sluggish international response and sheer lack of funds mean that the DRC has almost no access to vaccines. The price of an mpox shot is estimated at $100 (£77). This puts mass vaccination programs well beyond the reach of governments already unfairly burdened by excessive debt repayments to Western creditors. Acts of generosity on the part of richer countries have so far been small-scale and insufficient. The US has pledged 50,000 shots, but has the capacity to provide many more of the millions of doses that will be needed.
Along with other wealthier nations, the US must step up to the plate. The African Union’s public health agency estimates that around $4 billion will be needed across the continent to undertake vaccination, surveillance and education, focusing on a region already ravaged by poverty, malnutrition and conflict. Only a fraction of that has been promised so far. Having collectively taken his eye off the ball after last year’s less serious mpox outbreak in central Africa, the international community is now faced with a more dangerous situation for which it has not prepared.
During Covid, richer countries are notorious hoarded vaccines to a scandalous extent. Boosters were delivered to the citizens of the global north as low-income nations scrambled for cash and access to deliver first doses to their populations. In the future, there must be long-term solutions to promote greater vaccine equity, including technology transfer to poorer countries. At the moment, however, a belated sense of urgency and focus is needed to address a foreseeable crisis in the DRC and neighboring central African states.
