Why are mpox vaccines only just reaching Africa after being available since 2022? According to reports, the first 10,000 doses of mpox vaccines are set to arrive on the continent next week, which marks the start of the roll-out of these vaccines outside of clinical trials. This significant moment for public health arrives as the mpox virus has caused increasing concern globally, particularly due to the emergence of the clade Ib strain. This new strain has spread from the Democratic Republic of Congo (DRC) to neighboring nations, thrusting the issue of vaccine access front and center.
Elisabeth Furaha, a mother residing in a repurposed Ebola treatment center near Goma, knows the pressing need for these vaccines. She cares for her seven-year-old son, Sagesse Hakizimana, who suffers from mpox, and her fear is palpable. "Imagine fleeing a war and then losing your child to this illness," she says, echoing the desperate conditions faced by many families. Her situation highlights the challenge faced by healthcare systems struggling to cope with this resurgence of infectious disease.
The sluggish speed at which vaccines are reaching Africa reveals broader issues within the global health framework. Various public health officials and scientists have explained to Reuters the systemic failure of the global distribution network for vaccines, tests, and treatments, particularly toward lower-income countries.
This isn’t the first time mpox has been of concern. Two years prior, another strain was widely recognized, leading to the rapid repurposing of the smallpox vaccine. High-income nations reacted swiftly then, distributing millions of doses to protect vulnerable populations. For example, 1.2 million people were vaccinated against mpox in the United States, according to the US Centers for Disease Control and Prevention (CDC). Yet, now, as mpox arrives with urgency, the focus has shifted to Nigeria for these initial doses, rather than the DRC, where most cases are reported.
Helen Rees, who sits on the Africa CDC's mpox emergency committee, emphasized the importance of equitable access to vaccines. "The issue of access is the one thing we need to really shout about," she asserted, decrying the continuing inequities observed since the onset of the COVID-19 pandemic. The lack of prompt vaccine distribution to Africa is reminiscent of past public health emergencies, and Rees advocates for rapid access mechanisms to combat such health crises moving forward.
The situation on the ground is compounded by more than just delays. Inside the DRC, there has been considerable foot-dragging by health authorities, who only approved the mpox vaccine's use domestically back in June. Funding shortages and competition from other outbreaks, including Ebola, have also contributed to this delay. Despite the obvious need, the World Health Organization (WHO) has not yet officially approved the two main vaccines, developed by Bavarian Nordic and KM Biologics, which hampers distribution efforts significantly.
The absence of WHO approval creates a bottleneck for organizations like Gavi and Unicef, both of which depend on established procedures to procure vaccines. With some recent vaccines awaiting approval, organizations can only work with donations, limiting their response capabilities. Notably, just this month, the WHO called for manufacturers to submit documentation for emergency licenses, with hopes of finalizing the process by September.
"We're actually witnessing some echoes from the past, similar to the narrative seen during the early responses to HIV," remarked Dr. Ebere Okereke from Chatham House's global health program, referencing the prolonged delays of treatment access for developing regions. She asserted the urgent need for comprehensive public health measures such as improved testing and surveillance alongside vaccine distribution.
Dr. Pierre-Olibier Ngadjole, who works with Medair, emphasized the urgency of the vaccinations. He stated, "Vaccines remain key to cutting off the transmission chain and preventing new infections. By boosting immunity, we can protect more individuals." There’s collective hope from healthcare professionals who see vaccines as integral to turning the tide against mpox and its associated health risks.
Though the timeline for mpox vaccines arriving on the African continent may feel delayed, the arrival marks the beginning of addressing some longstanding health inequities. With the administration of new vaccines, communities like those of Ms. Furaha may finally find relief from the stresses of infectious disease. The need for swift, accessible healthcare responses remains, underscoring the challenge of future health emergencies, as public health officials and organizations work to rewrite the narrative around health access and distribution.
