A mutated form of mpox has been circulating in the Democratic Republic of Congo for months.
A mutated form of the mpox virus has been circulating in the Democratic Republic of Congo for months. Now, the response to what has become a global health emergency faces a key hurdle: the country still does not have a single vaccine.
The lack of vaccines and difficulties in understanding the spread of the disease in the Central African country highlight how delays on the ground, lack of international coordination and funding problems have hampered a rapid response.
The chain of delayed reactions to the crisis began during the last MPOX emergency that ended in 2023, when the Africa Centers for Disease Control and Prevention said the continent did not receive adequate support.
Even as the threat of mpox virus resurfaced and the organization responsible for global vaccine distribution expressed concern, Congo refrained from formally requesting vaccine donations. The country’s drug regulators only approved emergency use of the vaccines in June.
Meanwhile, several countries, organizations and potential donors are trying to help, but are only just beginning to coordinate a joint response.
“I don’t think the world has learned that there was no point in stopping the World Health Organization emergency last year,” Tulio De Oliveira, director of the Centre for Epidemic Response and Innovation at Stellenbosch University, said in an interview. “If we had learned that, we would have focused on stopping the outbreak.” Some experts disagree that the emergency declaration should have been continued.
According to Peter Sands, director of the Global Fund to Fight AIDS, Tuberculosis and Malaria, global attention has been focused on other issues. Mpox has been in Congo for a long time and “hasn’t gotten a lot of attention,” Sands said in an interview.
War and other threats have demanded the attention of governments since the end of the Covid-19 pandemic, but the mpox outbreak should be a reminder that if disease surveillance and basic primary care are neglected, “that can come back to bite us,” Sands said.
The situation in Congo has been complicated by multiple other health threats, including measles outbreaks and a humanitarian crisis, with 1.7 million internally displaced people in the province where the outbreak occurred. There are about 15,700 suspected cases of mpox, but the real number is likely much higher.
For one of the world’s poorest countries, the crisis requires a financial response that it is not able to afford. Roger Kamba, Congo’s Minister of Public Health, estimates that 3.5 million doses will be needed at a cost of hundreds of millions of dollars.
Coordinated response
One of the organizations responsible for global vaccination efforts, Gavi, began holding daily meetings to discuss the outbreak in Congo in May. As of last Thursday, it was still waiting for Congo to formally request vaccines. The country does not have mpox vaccines for the emergency response, but has requested doses from the United States and Japan, Samuel Boland, mpox incident manager for the WHO in Africa, told Bloomberg.
Coordination will be key to the response, said Gavi CEO Sania Nishtar. “We are all talking to the same donors, and that is very good news, but we need to coordinate and we hope that in the coming days there will be a coordination mechanism,” she said.
Vaccine donations could come from countries that already have stocks. The United States plans to donate 50,000 doses, but has millions more. The United Kingdom has confirmed it also has stocks, without giving further details. Germany has 117,000 doses.
“The sad thing is that the vaccines are ready to be distributed and there are certain things that prevent these countries from having access to them,” said Javier Guzman, director of global health policy at the Center for Global Development. Without a quick response, the disease will spread to other countries, he said.
Following the initial donations, vaccines will need to be ordered from manufacturers such as Bavarian Nordic A/S. When the state of emergency was declared, those discussions were limited, according to the Danish company’s chief executive, Paul Chaplin.
“COVID and also the mpox outbreak of 2022-23 should have taught everyone that you cannot ignore an outbreak in one part of the world,” he said.
First published: August 19, 2024 | 11:35 a.m. IS
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