LONDON (AP) – A move by rich countries to buy large quantities of a monkeypox vaccine could leave millions unprotected against a more dangerous version of the disease by refusing to share doses with Africa and risk the virus spreading to humans and communities. Health officials are on alert.
Critics fear a repeat of catastrophic inequality problems observed during the coronavirus pandemic.
“The mistakes we saw in the COVID-19 pandemic are already being repeated,” said Dr. Boguma Kabisen Titanji, assistant professor of medicine at Emory University.
While wealthy countries have ordered millions of vaccines to stop monkeypox on their borders, none have announced plans to share doses with Africa, where a more deadly strain of monkeypox is spreading than in the West.
To date, more than 22,000 monkeypox cases have been reported in nearly 80 countries since May, with about 75 deaths in Africa, mostly in Nigeria and Congo. Brazil and Spain reported monkeypox-related deaths on Friday, the first outside Africa. Spain reported a second monkeypox death on Saturday.
“African countries that have been dealing with monkeypox for decades have been relegated to a footnote in talks about the global response,” Titanji said.
Unlike campaigns to stop COVID-19, there is no need for mass vaccination against monkeypox, scientists say. They believe that targeted use of available doses, along with other measures, could halt outbreaks that the World Health Organization recently designated as global health emergencies..
But monkeypox is more difficult to spread As with Covid-19, experts say that if the disease spreads to the general population – currently in Europe and North America it is almost exclusively among gay and bisexual men – the need for vaccines may increase, especially if the virus takes root in new areas.
On Thursday, the African Centers for Disease Control and Prevention called on the continent to prioritize vaccines.said that he was lagging behind.
“If we are not safe, the rest of the world is not safe,” said Ahmed Ogwell, acting director of the Africa CDC.
Although monkeypox has been endemic in parts of Africa for decades, it has not spread far from the continent, mostly jumping from infected wild animals to humans.
Experts suspect that monkeypox in North America and Europe may have originated in Africa before the two species spread sexually. in Spain and Belgium. Currently, more than 70% of monkeypox cases worldwide are in Europe, and 98% are men who have sex with men.
Catherine Smallwood, the WHO’s senior emergency officer for Europe, said the deaths in Spain had not changed the agency’s assessment of the outbreak.
“Although the disease is self-limiting in most cases, monkeypox can have serious consequences,” he said in an email, noting that about 8% of infections require hospitalization and that monkeypox can sometimes lead to life-threatening complications such as encephalitis.
“As monkeypox continues to spread in Europe, we will see more deaths,” Smallwood said.
WHO is developing a vaccine sharing mechanism for affected countries, but has released few details on how it will work. The UN health agency made no guarantees about prioritizing poor countries in Africa, saying only that vaccines would be distributed based on epidemiological need.
Some experts fear the mechanism could replicate the problems seen with COVAX, established in 2020 by WHO and partners to provide COVID-19 vaccines to poor countries. This missed repeated targets to share vaccines with poorer nations.
“It’s not going to be enough to ask countries to share,” said Sharmila Shetty, vaccines adviser at Doctors Without Borders. “The longer monkeypox persists, the more likely it is to enter animal reservoirs or spread to humans,” he said.
Currently, there is only one manufacturer of the leading monkeypox vaccine: the Danish company Bavarian Nordic. Its production capacity this year is 30 million doses, and now there are about 16 million vaccines.
In May, Bavarian Nordic asked the U.S. to release more than 215,000 doses, which it was supposed to receive “to help with international requests the company receives,” according to Bill Hall, a spokesman for the Department of Health and Human Services. The US will still receive doses, but later.
The company declined to specify which countries it is distributing the doses for.
Hall said the U.S. has made no other promises to share vaccines. The US ordered the most doses, with 13 million stored, but only about 1.4 million delivered.
Some African officials said it would be wise to stockpile some doses on the continent, especially given the challenges faced by Western countries with monkeypox.
“I really didn’t think it would spread very far because monkeypox doesn’t spread like COVID,” said Salim Abdul Karim, an infectious disease epidemiologist at the University of KwaZulu-Natal in South Africa. “Africa should look for some vaccines if we need them, but we need to prioritize diagnosis and surveillance to know who to target.”
Dr. Ingrid Katz, a global health expert at Harvard University, said the monkeypox epidemic was “manageable” if limited vaccines were properly distributed. He believes it is still possible to prevent monkeypox from becoming a pandemic, but “we need to be thoughtful in our prevention strategy and we need to respond quickly.”
In Spain, which has the largest monkeypox outbreak in Europe, demand for vaccines far outstrips supply.
“There is a real gap between the number of vaccines we have now and the people who could benefit,” said Pep Coll, medical director of the Barcelona Health Center, which is firing the shots this week.
Daniel Rofin, 41, was thrilled to be offered a dose. He said he decided to get vaccinated for the same reasons he got vaccinated against COVID-19.
“I believe this is one way to stop the spread,” he said. “We (gays) are a risk group.”
Joseph Wilson and Renata Brito in Barcelona, Spain, Chris Megerian in Washington, D.C., and Kara Anna in Nairobi, Kenya, contributed to this report.