In Monkeypox Vaccine Race, Experts See COVID Repeat

If wealthy countries move to buy monkeypox vaccines in large quantities while refusing to share doses with Africa, millions of people will be protected from more dangerous versions of monkeypox. Public health officials have warned that the virus could continue to spread to humans.

Critics fear a repeat of the devastating inequality problems seen during the coronavirus pandemic.

“The mistakes we saw during the COVID-19 pandemic are already being repeated,” said Dr. Boghuma Kabisen Titanji, an assistant professor at Emory University School of Medicine.

Wealthy nations have ordered millions of vaccines to stop monkeypox in their own countries, but only one has announced plans to share doses with Africa, where monkeypox is more deadly than the West. There is none.

To date, nearly 80 countries have reported more than 21,000 monkeypox cases since May, with about 75 suspected deaths in Africa, primarily Nigeria and Congo. On Friday, Brazil and Spain reported the first monkeypox-related deaths reported outside Africa. On Saturday, Spain reported her second monkeypox death.

“African countries dealing with monkeypox outbreaks for decades have been relegated to a footnote in the conversation about the global response,” said Titanzi.

Scientists say mass vaccination against monkeypox is not necessary, unlike campaigns to stop COVID-19. They believe that targeted use of available doses and other measures can stop the growing epidemic recently designated as a global emergency by the World Health Organization.

But while monkeypox is much more difficult to spread than COVID-19, experts say that if the disease spreads to the general population (currently in Europe and North America, among gay and bisexual men) (almost exclusively prevalent in the United States), especially warning that the need for vaccines may increase. if the virus takes hold in a new area.

On Thursday, the African Center for Disease Control and Prevention said the continent was being left behind again and called on the African continent to prioritize a vaccine.

“If we are not safe, the rest of the world is not safe,” said Ahmed Ogwell, deputy director of the Africa CDC.

Although endemic in parts of Africa for decades, monkeypox is most often transmitted to humans from infected wild animals and usually does not spread far beyond the continent.

Experts believe that monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease began spreading through sexual activity in two raves in Spain and Belgium. More than 70% of the world’s monkeypox cases are now in Europe, and 98% of his cases are men having sex with men.

The WHO is developing a vaccine-sharing mechanism for affected countries, but few details have been published about how it will work. Just saying that vaccines will be distributed based on need doesn’t make any guarantees about prioritizing poor African countries.

Some experts fear the mechanism could replicate problems seen with COVAX, produced by WHO and partners in 2020. This fell short of its recurring goal of sharing vaccines with poorer countries, sometimes relying on donations.

“It’s not enough to just ask countries to share,” said Sharmila Shetty, a vaccine adviser to Doctors Without Borders. “The longer a monkeypox epidemic lasts, the more likely it is to invade new animal reservoirs or spread to the general human population,” she said. can change significantly.”

Currently, only Bavarian Nordic in Denmark manufactures a state-of-the-art monkeypox vaccine. This year’s production capacity is about 30 million doses and about 16 million vaccines are currently available.

In May, Bayern Nordic asked the U.S. to release more than 215,000 doses it was due to receive “to support the international demands it was receiving,” and the U.S. complied, it said. Department of Health spokesman Bill Hall said. Human service. The US will continue to receive doses, but at a later date.

The company declined to specify which countries it allocates doses to.

Hall said the US has made no other commitments to share vaccines. The United States orders by far the most doses, with only about 1.4 million delivered but 13 million booked.

Some African officials said it would be prudent to stockpile several doses on the continent, especially given that Western countries are struggling to stop monkeypox.

Salim Abdul Karim, an infectious disease epidemiologist at the University of KwaZulu-Natal in South Africa, said, “Monkeypox doesn’t spread like COVID, so I really didn’t expect this to spread as much.” , we need to procure some vaccines in case we need them, but we need to prioritize diagnostics and surveillance so we know who to target,” he said. “We can usually get ahead of diseases like monkeypox, but the concern is that[the number of new cases]has not yet started to decline.”

Dr. Ingrid Katz, a global health expert at Harvard University, said monkeypox epidemics were “potentially manageable” if limited vaccines were properly distributed. She believed it was still possible to prevent monkeypox from becoming a pandemic, but she “needs to think carefully about prevention strategies and react quickly.”

In Spain, home to Europe’s largest monkeypox outbreak, demand for the vaccine far exceeds supply.

“There is a real gap between the number of vaccines currently available and the people who can benefit from them,” said Pep Koll, medical director of the Barcelona health center that was giving injections this week. said.

Daniel Roffin, 41, was very pleased with the recent offer. He said he decided to get vaccinated for the same reason he was vaccinated against COVID-19.

“I am relieved that this is the way to stop the spread,” he said. “We (gay men) are an endangered group.”