The Africa Centres for Disease Control and Prevention (Africa CDC) is in talks with Bavarian Nordic, the only global producer of an mpox vaccine, about technology transfer to enable African manufacturers to make the vaccine on the continent.

“I want to recognise and thank Bavarian Nordic for accepting to do the tech transfer in Africa, for Africa to manufacture the vaccine,” Africa CDC Director General Dr Jean Kaseya told a media briefing on Tuesday.

Kaseya added that Africa CDC aimed to have 10 million doses available by the end of 2025, and Bavarian Nordic “tell me the doses we are talking about are not a dream”. 

However, he acknowledged that this was a longer-term solution to the mpox outbreak affecting 12 African countries.

More immediately, the continent expects donations from wealthier countries during what Kaseya dubbed as the “emergency humanitarian era”. He thanked the European Union (EU) for assistance in procuring 215,000 vaccines.

In the past week, there has been an increase of 1,405 cases on the continent bringing the official total to 18,910 although Kaseya cautioned that surveillance was not optimal in some countries.

The biggest increase was in the Democratic Republic of Congo (DRC), the epicentre of the outbreak, which now has 17,794 cases (an increase of 1,030). 

However, armed conflict in eastern DRC is hampering efforts to curb the outbreak, and Kaseya thanked Angola’s president for his efforts to broker peace between the DRC and Rwanda, which has supported the M23 rebels in the DRC.

Cases in Burundi jumped from 265 to 572, while the Central African Republic also recorded more cases (up from 206 to 263) as did Nigeria, (from 24 to 39).

No new cases were recorded in Cameroon, Congo, Kenya, Rwanda, Uganda, South Africa, Côte d’Ivoire or Liberia.

There have been 541 recorded deaths.

Single incident management team

For the first time, the Africa CDC, the World Health Organization and UNICEF have united to form a single African incident management team to address the outbreak, which was declared a public health emergency of international concern (PHEIC) last week.

Professor Jean-Jacques Muyembe, general director of the Democratic Republic of the Congo Institut National pour la Recherche Biomedicale (INRB), told the Africa CDC briefing that better communication about the causes of mpox was necessary to prevent its spread.

Children to be warned against touching dead animals or eating jungle meat, he advised Almost 70% of mpox cases in the DRC involve children under the age of 16.

In addition, communities had to be educated about human-to-human transmission via bodily fluid, using all the lessons from  Ebola, HIV and COVID-19 including condom use and good hygiene. Mpox clade 2 has been spread primarily via sexual contact between men.

Muyembe also reported on a recent trial of an antiviral medicine, tecovirimat, to treat mpox. The trial was “discouraging” as tecovirimat failed to reduce the duration of mpox lesions in children and adults with clade I mpox in the DRC, he reported.

A small study with an increased dose of tecovirimat was currently underway.

However there was a 1.7% mortality rate in the trial – significantly lower than the mpox mortality of 3.6% in the DRC.

This mortality rate applied to all subjects regardless of whether they received tecovirimat or a placebo, indicating that “hospitalization and high-quality supportive care” improved outcomes regardless of treatment, according to a report from the US National Institutes of Health, which sponsored the trial.

More domestic resources

Over the weekend, South African President Ramaphosa – the African Union (AU) Champion on Pandemic Prevention, Preparedness, and Response (PPPR) – called on member states to devote more domestic resources to mpox.

Ramaphosa also urged the international community “to mobilise stockpiles of vaccines and other medical countermeasures for deployment in Africa” via Africa CDC.

“This is also an opportunity to call on the international community to finalise a fair and equitable pandemic agreement—a duty that must be pursued with urgency and a spirit of equity,” added Ramaphosa.