In race for monkeypox vaccines, experts see repeat of COVID

LONDON (AP) — Steps by wealthy countries to buy large quantities of monkeypox vaccine, while refusing to share doses with Africa, could leave millions unprotected from a more dangerous version. of the disease and risk continuing to spread the virus to humans, public health officials warn.

Critics fear a repeat of catastrophic inequality issues seen during the coronavirus pandemic.

“The mistakes we saw during the COVID-19 pandemic are already repeating themselves,” said Dr. Boghuma Kabisen Titanji, assistant professor of medicine at Emory University.

While wealthy countries have ordered millions of vaccines to stop monkeypox within their borders, none have announced plans to share doses with Africa, where a deadlier form of monkeypox spreads only in the West.

To date, more than 22,000 cases of monkeypox have been reported in nearly 80 countries since May, with around 75 suspected deaths in Africa, mostly in Nigeria and Congo. On Friday, Brazil and Spain reported monkeypox-related deaths, the first reported outside Africa. Spain reported a second death from monkeypox on Saturday.

“African countries that have faced monkeypox outbreaks for decades have been relegated to a footnote in conversations about the global response,” Titanji said.

Scientists say that, unlike campaigns to stop COVID-19, mass vaccinations against monkeypox will not be necessary. They believe targeted use of available doses, along with other measures, could stop expanding epidemics that were recently designated by the World Health Organization as a global health emergency..

Yet while monkeypox is much more difficult to spread than COVID-19, experts warn that if the disease spreads through the general population — currently in Europe and North America it circulates almost exclusively among gay and bisexual men — the need for vaccines could intensify, especially if the virus takes root in new regions.

On Thursday, the Africa Centers for Disease Control and Prevention called for prioritizing the continent for vaccinessaying he was left behind again.

“If we are not safe, the rest of the world is not safe,” said Africa CDC Acting Director Ahmed Ogwell.

Although monkeypox has been endemic in parts of Africa for decades, it mainly spreads among people from infected wild animals and has generally not spread very far beyond the continent.

Experts suspect monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease began to spread sexually at two raves in Spain and Belgium. Currently, more than 70% of monkeypox cases worldwide are in Europe and 98% are in men who have sex with men.

Catherine Smallwood, senior emergency manager at WHO Europe, said the deaths in Spain did not change the agency’s assessment of the outbreak.

“Although the disease resolves on its own in most cases, monkeypox can lead to serious complications,” she said in an email, adding that around 8% of reported infections had required hospitalization and that monkeypox could sometimes lead to life-threatening complications such as encephalitis.

“With the continued spread of monkeypox in Europe, we expect to see more deaths,” Smallwood said.

WHO develops vaccine sharing mechanism for affected countries, but released few details on how it might work. The UN health agency made no guarantees that it would prioritize poor countries in Africa, saying only that vaccines would be distributed based on epidemiological need.

Some experts fear that the mechanism will reproduce the problems encountered with COVAX, created by the WHO and its partners in 2020 to try to ensure that the poorest countries would get vaccines against COVID-19. This has missed repeated goals of sharing vaccines with poorer countries.

“It will not be enough to ask countries to share,” said Sharmila Shetty, vaccine adviser for Doctors Without Borders. “The longer the monkeypox circulates, the greater the risk of it entering new animal reservoirs or spreading” to the general human population, she said.

Currently, there is only one producer of the most advanced monkeypox vaccine: Danish company Bavarian Nordic. Its production capacity this year is around 30 million doses, with around 16 million vaccines currently available.

In May, Bavarian Nordic asked the United States to release more than 215,000 doses it was to receive “to meet international requests the company was receiving,” and the United States complied, according to Bill Hall, a carrier. word of the Ministry of Health and Man. Services. The United States will still receive the doses, but at a later date.

The company declined to specify which countries it was assigning doses to.

Hall said the United States made no further promises to share vaccines. The United States has ordered the most doses by far, with 13 million reserved, although only around 1.4 million have been delivered.

Some African officials have said it would be wise to stockpile some doses on the continent, especially given the difficulties Western countries have had in stopping monkeypox.

“I really didn’t think it would spread very far because monkeypox doesn’t spread like COVID does,” said Salim Abdool Karim, an infectious disease epidemiologist at the University of KwaZulu-Natal in South Africa. “Africa should get vaccines in case we need them, but we should prioritize diagnosis and surveillance so we know who to target.”

Dr Ingrid Katz, a global health expert at Harvard University, said monkeypox outbreaks were “potentially manageable” if limited vaccines were distributed appropriately. She believed it was still possible to prevent monkeypox from becoming a pandemic, but “we need to be thoughtful in our prevention strategies and quick in our response.”

In Spain, which is experiencing the largest outbreak of monkeypox in Europe, demand for vaccines far exceeds supply.

“There is a real gap between the number of vaccines we have now and the people who could benefit from them,” said Pep Coll, medical director of a Barcelona health center which was giving injections this week.

Daniel Rofin, 41, was more than happy to be offered a dose. He said he decided to get vaccinated for the same reasons he was immunized against COVID-19.

“I’m reassured it’s a way to stop the spread,” he said. “We (gay men) are an at-risk group.”

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Joseph Wilson and Renata Brito in Barcelona, ​​Spain, Chris Megerian in Washington and Cara Anna in Nairobi, Kenya contributed to this report.

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