London – Public health officials have warned that moves by wealthy nations to buy large quantities of the monkeypox vaccine, while refusing to share doses with Africa, could leave millions of people unprotected against a more serious version of the disease and risk the virus continuing to spread in humans.
Critics fear a repeat of the catastrophic inequality problems seen during the coronavirus pandemic.
“The mistakes we saw during the COVID-19 pandemic are already repeating,” said Dr. Bogoma Kapisin Tetanji, an assistant professor of medicine at Emory University.
While rich countries have requested millions of vaccines to stop monkeypox within their borders, none has announced plans to share doses with Africa, where a more deadly form of monkeypox is spreading than in the West.
So far, more than 22,000 cases of monkeypox have been reported in nearly 80 countries since May, with about 75 suspected deaths in Africa, mostly in Nigeria and Congo. On Friday, Brazil and Spain reported deaths linked to monkeypox, the first case reported outside Africa. Spain reported its second death from monkeypox on Saturday.
“African countries that have been dealing with monkeypox outbreaks for decades have been left to the sidelines in conversations about a global response,” Titangi said.
Scientists say that unlike campaigns to stop COVID-19, mass vaccinations against monkeypox would not be necessary. They believe that the targeted use of available doses, along with other measures, could stem the spread of epidemics that the World Health Organization recently designated as a global health emergency.
However, while monkeypox is much more difficult to spread than COVID-19, experts warn that the disease in the general population — currently in Europe and North America, spread almost exclusively among gay and bisexual men — could increase the need for vaccines, especially If the virus takes hold in new areas.
On Thursday, the African Centers for Disease Control and Prevention called for the continent to prioritize vaccines, saying it was once again lagging behind.
“If we are not safe, the rest of the world will not be safe,” said Ahmed Ogweel, acting director of the Africa Centers for Disease Control and Prevention.
Although monkeypox has been endemic to parts of Africa for decades, it is mostly transmitted to humans from infected wild animals and has not usually spread beyond the continent.
Experts believe monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease spread through sex in two raves in Spain and Belgium. Currently more than 70% of monkeypox cases in the world are found in Europe, and 98% are among men who have sex with men.
Catherine Smallwood, the World Health Organization’s emergency official in Europe, said the deaths in Spain did not change the agency’s assessment of the outbreak.
“Although the disease is self-healing in most cases, monkeypox can cause serious complications,” she said in an email, adding that about 8% of reported infections require hospitalization and that monkeypox can sometimes lead to life-threatening complications. Life is like encephalitis.
“As monkeypox continues to spread in Europe, we expect to see more deaths,” Smallwood said.
The World Health Organization is developing a mechanism for sharing vaccines for affected countries, but has released few details on how it will work. The UN health agency offered no guarantees about prioritizing poor countries in Africa, saying only that vaccines would be disbursed on the basis of epidemiological need.
Some experts worry that the mechanism may repeat problems seen with COVAX, which the World Health Organization and its partners set up in 2020 to try to ensure poor countries get the COVID-19 shots. It missed the repeated goals of sharing vaccines with poor countries.
“Just asking countries to get involved will not be enough,” said Sharmila Shetty, a vaccines consultant for Doctors Without Borders. “The longer monkeypox spreads, the greater the chances that it will reach new animal reservoirs or spread to ‘the general public,'” she said.
At the moment, there is only one producer of the most advanced monkeypox vaccine: the Danish North Bavarian company. This year, its production capacity is about 30 million doses, with about 16 million vaccines now available.
In May, North Bavaria asked the US to release more than 215,000 doses it was due to receive “to help with international orders the company was receiving,” and the US complied, according to Bill Hall, a spokesperson for the Department of Health and Human Rights. services. The United States will continue to receive the doses but at a later time.
The company declined to specify the countries to which it allocates doses.
The United States has not made any further promises to share vaccines, Hall said. The United States has so far ordered the largest number of doses, with 13 million on hold, although only about 1.4 million have been delivered.
Some African officials said it would be wise to stock up on some of the doses on the continent, especially given the difficulties Western countries are having in stopping monkeypox.
“I really didn’t think this would spread very far, because monkeypox doesn’t spread like COVID,” said Salem Abdulkarim, an infectious disease epidemiologist at the University of KwaZulu-Natal in South Africa. “Africa should buy some vaccines in case we need them, but we must prioritize diagnosis and surveillance so we know who to target.”
Dr. Ingrid Katz, a global health expert at Harvard University, said monkeypox epidemics could be “controllable” if limited vaccines were distributed appropriately. She believes that monkeypox can still be prevented from becoming a pandemic, but “we need to think carefully about our prevention strategies and speed in our response.”
In Spain, which has the largest outbreak of monkeypox in Europe, the demand for vaccines far exceeds supply.
“There is a real gap between the number of vaccines we currently have and the people who could benefit from them,” said Pep Cole, medical director at the Barcelona Health Center who was distributing the injections this week.
Danielle Ruffin, 41, was more than happy when he was given a dose. He said he decided to get vaccinated for the same reasons he was vaccinated against COVID-19.
“I feel reassured that it is a way to stop the spread,” he said. “We (gay men) are a group in danger.”
Joseph Wilson and Renata Brito in Barcelona, Spain, Chris Mejeran in Washington, and Kara Anna in Nairobi, Kenya contributed to this report.