Fiona Chisholm, Associate Director of Infectious Diseases, GlobalData, offers her view:
“A PHEIC declaration is the highest level of alert that the WHO can issue and reflects the gravity of the situation in Africa, where an unprecedented increase in mpox cases has been reported in recent weeks. This is a call to action for countries and donor agencies worldwide to cooperate in order to contain the outbreak. The WHO’s decision also echoes that of the Africa Centres for Disease Control and Prevention (Africa CDC), which declared a Public Health Emergency of Continental Security (PHECS) just a day earlier.
“Mpox, formerly known as monkeypox, is a viral infection that causes symptoms such as pus-filled lesions and fever. It can be transmitted by contact with an infected person, animal, or contaminated materials. While most people recover within a few weeks, mpox can lead to serious complications such as sepsis, pneumonia, and severe dehydration, and can be fatal. This is particularly the case for immunocompromised individuals, such as those with HIV.
“What is particularly concerning about the current outbreak is that it is predominately being driven by a novel strain of the virus known as clade Ib, which was first detected in the Democratic Republic of the Congo (DRC) in September 2023. Clade Ib appears to be more virulent than clade II, the strain that was responsible for the 2022 mpox outbreak*, and children appear to be particularly susceptible to this strain.
“In 2024 to date, suspected cases across Africa have exceeded 17,000 and over 500 deaths have been reported, although, this is likely an underestimate. Cases have primarily occurred among children in the DRC, but at least 12 other African countries have also reported outbreaks including previously unaffected nations like Burundi, Kenya, Rwanda, and Uganda.
“Procurement of vaccines to distribute to populations most at risk should now be a key priority in order to contain the outbreak and save lives. Bavarian Nordic’s MVA-BN vaccine (Jynneos/Imvanex), which is approved in the US, Europe, and Canada, is the leading mpox vaccine worldwide. Additionally, KM Biologics’ LC16 vaccine is available in Japan and Emergent BioSolutions’ ACAM2000 is also under regulatory review for mpox in the US. Mpox vaccines played an important role in containing the 2022 mpox outbreak in high-income nations, but none are currently widely available in Africa.
“The Africa CDC has estimated that it will need around 10 million vaccine doses in order to manage the outbreak. As an immediate response, the European Commission announced that it will donate 175,420 doses of the MVA-BN vaccine to the Africa CDC, while Bavarian Nordic will donate 40,000 doses. Bavarian Nordic has also confirmed that it has the capability to produce 10 million doses of the vaccine by the end of 2025 and is waiting to receive orders.
“Nonetheless, vaccines will remain in extremely short supply across countries currently dealing with soaring cases, at least in the short term. This highlights the need for a coordinated international response that ramps up pressure on countries with stockpiles to donate their mpox vaccines.”
*The WHO previously declared a PHEIC for an mpox outbreak in July 2022, which was lifted in May 2023
Edits made by EH News Bureau