Understanding local and global challenges to the MPOX outbreak

On the 13th August 2024, the Africa Centres for Disease Control and Prevention (Africa CDC) officially declared the ongoing MPOX outbreak a Public Health Emergency of Continental Security (PHECS), marking the first such declaration by the agency since its inception in 2017. Africa CDC Director General Dr Jean Kaseya emphasised the urgency of the situation. Subsequently, the WHO declared the MPOX outbreak a public health emergency of international concern (PHEIC) on 14th August 2024.

The ongoing mpox outbreak has been a public health emergency a long time in the making. In December 2022, the Democratic Republic of the Congo (DRC) declared a national outbreak of MPOX based on the increasing number of reported cases. Communities across the DRC face challenges around risk communication, contact tracing, treatment, access to laboratory tools, and isolation of cases according to Dr Elia Badjo of COSAMED, a local team of health providers and Matahari’s local partner in DRC. “Medicines, adequate care, access to testing are lacking in the community,” he explains.

A 2023 report by Matahari Global highlighted the inequities in R&D and access to MPOX diagnostics. This, despite the decades-long history of outbreaks in the region. Today, it is unclear if the recommendation that countries establish laboratory diagnostic and genomic sequencing capacity for viruses such as MPOX has been put into place. As reports of donations of vaccines arriving in few African countries, the region still has a long way to go.

Africa CDC has signed a partnership agreement with the European Commission’s Health Emergency Preparedness and Response Authority (HERA) and Bavarian Nordic to provide over 215,000 doses of the MVA- BN (Modified Vaccinia Ankara – Bavarian Nordic) vaccine. Alongside this, UNICEF has issued an emergency tender for the procurement of MPOX vaccines, which will hopefully help secure mpox vaccines for the hardest hit countries in collaboration with Africa CDC, Gavi, the Vaccine Alliance, WHO, the Pan American Health Organization and other partners. However local/regional manufacturing is essential in order to drive vaccine prices down. A 2022 Public Citizen report found that six manufacturers could make vaccines for MPOX for $4 or less per dose, nearly 30 times less than the estimated $110 price of the MPOX vaccine.

Our 2023 report recommended that governments, donors, and development banks should offer more funding to support the full pipeline of diagnostics production, as well as an increase in regional coordination efforts towards the many aspects of the outbreak. With the declaration of the PHECS, the Africa CDC is already playing such a role.

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By Charles Ebikeme, Associate Consultant for Health Systems