MPOX vaccination in Africa: what's next – Democratic Republic of the Congo

by Orin Levin, Javier Guzman and Janine Madan Keller

There has been a recent surge in mpox cases across Africa, including in previously unaffected countries, and there is a strong need for increased resources to mount a rapid and equitable response. The good news is that we are beginning to respond to calls for access to vaccines as part of the epidemic response.

Although the need for vaccines remains great, some governments are us, Japanand european partner Among other things, it has recently been active in pledging millions in vaccine donations to African countries. Furthermore, the World Health Organization pre-qualified Vaccines from the Northern European state of Bavaria. An important step to enable purchases by international funders. Gabi, Vaccine Alliance wasted no time after pre-qualifying and subsequently secured vaccinations. advance purchase agreement Money from the new First Response Fund will procure 500,000 doses of vaccine, further boosting global vaccine efforts.

But securing vaccine donations and purchases is only the first step. Although it is necessary insufficient By itself. To truly prevent further spread and protect our communities, we need to do more next. This blog looks at three priorities: targeting vaccinations to the right groups, strengthening distribution systems, and building public confidence to direct vaccine doses to the most affected areas on the ground. This will lead to vaccination of society.

Prioritize people at risk

Vaccine donations and purchase agreements have recently evolved, and leaders of affected countries will need to decide how to allocate available vaccines. For example, will the allocation of vaccine doses be focused on controlling an outbreak that spreads beyond the borders of the Democratic Republic of the Congo (DRC)? Or will the focus be on preventing a greater burden of disease that continues to occur in high-risk areas of the Democratic Republic of the Congo?

Recent global attention has focused on outbreaks caused by subclade Ib. The strain has spread beyond the Democratic Republic of the Congo to neighboring Burundi, Kenya, Uganda, and Rwanda; Detected outside Africa. However, the majority of mpox cases worldwide originate from subclade Ia, which is characterized by animal-to-human transmission in central DRC. Although both subclades affect children, most cases and deaths still come from subclade Ia, which is endemic in the Democratic Republic of the Congo and has received less attention despite its impact.

If the priority is to prevent the most cases, health care workers, people living with compromised immune systems, and vulnerable communities in areas where mpox is known to occur should be prioritized. is. Ultimately, how vaccine doses are allocated will determine which disease control goals are prioritized.

Strengthen vaccination provision

Not only identifying priority groups, but also ensuring the vaccine reaches everyone who needs it, is no easy task. Need for timely response Support for each country Preparing for deployment and last-mile delivery was also an important lesson learned from the COVID-19 response.

Immunization coverage in the DRC has historically been difficult, with even inexpensive routine vaccines such as the measles vaccine struggling. rarely exceeds 70% coverage in many parts of the country.

Strengthening immunization delivery systems, from human resources to storage and transportation, is essential. Fixes will not be quick and easy, but without investment and a continued focus on strengthening delivery systems, vaccines will ultimately not be the vaccines that protect our communities. And leveraging early support, including timely funding from, for example, the World Bank and UNICEF, can help, alongside close collaboration with humanitarian partners in conflict-affected areas.

Continued investment in the immunization supply system will also open opportunities to expand limited vaccine supplies. split administrationan approach that will become easier to adopt as delivery systems become stronger.

Avoid bias, build trust, and engage the community early

If past outbreaks have taught us anything, it's that avoiding stigma and building community trust is essential. Stigmatizing people at risk can lead to fear, discrimination and delays in care, as we have seen with Ebola and HIV. During the COVID-19 vaccine rollout in Africa, even health workers were hesitant to get vaccinated despite their high-risk status due to a lack of trust. As mpox vaccination ramps up in Africa, it will be essential to work proactively to prevent the same mistakes.

Inclusive messages that focus on health risks rather than specific group identities can help avoid stigma. It is important to communicate how mpox can affect everyone, not just certain groups. This avoids language that reinforces stereotypes about who is at risk.

To reduce hesitancy, public health officials need to be aware of the concerns and provide clear and culturally appropriate explanations of the safety and benefits of the mpx vaccine. Health authorities need to start engaging with communities early, listening to concerns, meeting people where they are, and involving them in the process of deciding how to prevent the disease, including vaccination. Using trusted channels and locally relevant approaches is key to building support and controlling the disease. Early involvement is also essential to reduce future hesitation.

conclusion

The donation of mpox vaccines to Africa is an important first step, but there is still much work to be done to ensure these vaccines are used effectively and equitably. By focusing on Vaccination targeting appropriate groupsreinforcement delivery system, and the building public trust via Early community involvementvaccination can protect African communities from future mpox outbreaks.

Disclaimer

CGD blog posts reflect the authors' opinions based on prior research and experience in their fields of expertise. CGD is a nonpartisan, independent organization and takes no institutional position.