As U.S. public health officials brace for a potential resurgence of mpox ahead of the summer festival season, experts warn that European and North American governments are not doing nearly enough to ensure that hard-hit African countries can also contain the virus.

A vaccine for mpox existed before the outbreak in the US last year. Thanks in part to that vaccine, which is about 86% effective after two doses, cases of mpox in the US have plummeted from a peak of 600 new cases nationwide on Aug. 1.

2022, alone

to an average of one new case per week in April

2023

according to the U.S. Centers for Disease Control and Prevention.

But in lower-income countries, such as those African countries where mpox (the virus formerly known as monkeypox) is endemic, health officials still don’t have access to the vaccine. That can lead to the virus’

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return as a global threat.

The current global mpox outbreak was a result of inaction when it came to the outbreak in Africa, said Dr. Amesh Adalja, senior researcher at the Johns Hopkins Center for Health Security and an infectious disease physician who has treated patients with mpox. The strategy to contain monkeypox should be to vaccinate the population at risk in Western countries as well as vaccinate at source to prevent animal spillover.

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species to humans. You must do both.

But the

W

The Eastern world seems poised to repeat the same mistakes that led to the current outbreak.

After the

current

When the mpox outbreak began last spring, wealthy countries rushed to the sole maker of the Jynneos smallpox vaccine, Denmark’s Bavarian Nordic, to secure millions of doses.

On the same day that Boston registered the first case of mpox in the US, Bavarian Nordic announced the first in a series of contracts with the US Department of Health and Human Services. The $300 million deal would net the US 13 million doses. By the end of May, the US had administered 1.2 million doses, fully immunizing approximately 23% of the at-risk population, according to CDC data.

The European Union, Canada and other countries that Bavarian Nordic has not disclosed in company news announcements also purchased vaccines from the Danish biotechnology company. the multi

–

Million-dollar contracts have allowed the world’s richest countries to get to the front of the line for mpox vaccines to protect their citizens from the current outbreak and also build supplies for the future. Just as they had done with the COVID-19 vaccines, rich countries ordered almost all available and future vaccine doses, leaving poorer countries without the resources to protect their healthcare workers and the elderly.

In May, as the World Health Organization announced

it was coming to an end

the mpox

outbreak was no longer one

a public health emergency of international concern, it also warned of persistent knowledge gaps regarding mpox in Africa, the lack of access to vaccines, medicines and diagnostic testing capacity in many low-income countries.

On the ground in Africa, senior health officials are concerned. This is a classic example of limited access for Africa for a product, in this case vaccines, said Dr Ahmed Ogwell Ouma, acting director of the

Africa centers

for disease control and prevention, based in Addis Ababa

Ethiopia

. Even if we wanted to buy it, we can’t buy it anywhere, because they are produced in modest numbers and countries store them in case they need them, while where it’s really needed, on the African continent, we don’t have access.

The continent’s health officials have battled for decades with smaller outbreaks without access to vaccines. Africa has recorded about 1,600 so far

mpox

cases and 18 deaths, according to data reported to WHO. Actual figures may be higher due to limited testing and reporting resources.

Experts say the current outbreak could have been prevented from crossing multiple borders if the virus had been contained at its source. According to data from the US CDC, 104 countries that had never previously recorded a case of mpox have now discovered the virus in the past year.

Ouma believes that if African countries had received vaccine support, the world would have been spared the outbreak. “The outbreak that went global last year would not have happened if there was access to mpox vaccines on the African continent, because then we could have contained the outbreak at its source.”

to pray

administration

officials acknowledge that without suppression of the virus abroad, the US will remain vulnerable at home. Everyone is aware that even if we vaccinated very well domestically, as long as there is mpox that is transmitted around the world in this way, we are always at risk of an outbreak and introduction,” Dr. Demetre Daskalakis, Deputy coordinator for the national MPOX response at the White House, told The Times.

Even before the current outbreak, the United States has been amazing with millions of mpox vaccines for years. For fear of bioterrorism in the aftermath of the

Sept. 11, 2001, Sept. 11

attacks, the US invested heavily in Bavarian Scandinavian and stockpiled more than 20 million doses of the Jynnesos vaccine. This is in addition to more than 100 million doses of another vaccine, ACAM2000, which, while effective, can be potentially lethal to a small group of patients and is therefore not favored by doctors.

US officials allowed 20 million doses of the Jynnesos vaccine to expire and be thrown away without sharing with other countries. When the outbreak began, the country only had 2,400 doses in stock.

So far, only South Korea has pledged to donate 50,000 doses of the vaccine to the Africa CDC for

forward

distribution to countries, but those vaccines have yet to be delivered. Ouma said talks with the United States and the European Union are still ongoing. “There are some regulatory issues that are being worked on,” Daskalakis told The Times.

experts

like inclusive

Adalia with John

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Hopkins points to Ebola, another viral outbreak, as a model of how international cooperation on global health security has ensured that a deadly virus has been contained in its endemic regions, not across borders. When there is an Ebola outbreak in Africa, there is an aggressive response to put it out, to provide relief, to use vaccines and experimental therapies to keep it at bay, he said.

Since the devastating 2014-2016 Ebola outbreak that killed 11,300 people, governments, pharmaceutical companies and global health agencies have worked together to fight the disease and develop a treatment and two vaccines for the Ebola strain that ravaged West Africa. The vaccines have proven to be very effective and have been deployed locally during subsequent outbreaks where that strain spreads to suppress it locally.

Meanwhile, African governments are trying to take matters into their own hands to make the vaccines they need at home. In April, a pharmaceutical company in Ghana began construction of a factory that would produce vaccines against malaria, HPV and pneumonia

local

share with neighboring countries. The Africa CDC is also leading a continent-wide initiative to produce key vaccines.

By doing that, we will improve access to these vaccines,” Ouma said. “Otherwise what is happening now is not ideal, it is not good, it is not viable. It’s not safe for the whole world.”