Africa Has Not Received a Single Dose of Monkeypox Vaccine – Even Though Virus is Endemic and Often More Deadly
WHO African Regional Director, Dr Matshidiso Moeti

Another COVID rerun: WHO and Africa CDC officials lament the complete lack of access to monkeypox vaccines on the continent where the virus is endemic – as well as often more deadly than elsewhere. Meanwhile, Mozambique and Malawi have seen a total of six wild poliovirus cases, although WHO officials continue to insist that since the cases are imported, this won’t affect Africa’s status as ‘wild poliovirus free.’

The African continent has not yet received any vaccine doses to combat the monkeypox virus, African health officials said Thursday, including nations where the disease is endemic and often more deadly than the clades surfacing around the world. 

More monkeypox testing kits also are urgently needed to improve the continent’s emergency response, top health officials warned in back-to-back briefings.  

“We still don’t have access to enough test kits. We are working on increasing that. We still don’t have access to any vaccines and that is a big concern,” said Africa CDC’s acting director, Ahmed Ogwell Ouma. 

He told Health Policy Watch that the sluggish response and lack of support for African countries doesn’t match the urgency called for in WHO’s declaration of monkeypox as a global public health emergency (PHEIC).

“We need a coordinated international response where more is being put on the table to support the control of monkeypox as an outbreak of international concern,” Ouma said, stressing that Africa CDC has been providing as much guidance and support as it can for training and surveillance. 

Tedros Adhanom Ghebreyesus, WHO Director General, had declared monkeypox a public health emergency in July.

Though no vaccines are available, WHO African Regional Director, Dr Matshidiso Moeti, said testing capacity is at least expanding, but not fast enough.

“We have finally been able to obtain some tests, supplies and we have distributed these among countries to enable more rapid testing and confirmation of cases of monkeypox that will enable the diagnosis and ensure actions are taken faster,” Moeti told journalists on the margins of the 72nd WHO Regional Committee for Africa.

She said WHO is working through its headquarters “to try to seek supplies of vaccines so that these may be available as we start to see new cases and we can have the experience of using this vaccine in Africa”.

The Danish manufacturing plant of Bavarian Nordic, sole producer of the only WHO-approved monkeypox vaccine, MVA-BN, has been closed for renovations since spring and is not expected to reopen until late 2022, leading to a dire shortage of global supplies.  

WHO has repeatedly said it is “discussing” with vaccine suppliers.

However, according to a recent Health Policy Watch investigation, there are only about 16.4 million stockpiled MVA-BN doses available in bulk or finished form until the end of this year.

Unless a license is awarded to another vaccine manufacturer, the world will have to make do with existing doses, most of which reside in the United States and a few other wealthy countries. See related story: 

Monkeypox Cases Drop 21% Globally As WHO Weighs ‘Fractional’ Vaccine Dose Strategy

Wild poliovirus cases expanding slowly  

Meanwhile, at a special African Regional Committee session on polio, WHO, African health ministers and their partners said they would work together to tackle wild poliovirus, which is seeing a comeback in east Africa due to the spread of a virus strain imported from Pakistan. 

There have now been six cases reported in the African Region from the outbreak which began last year in Malawi and has now reached Mozambique, all apparently with links to an imported case from Pakistan. 

WHO said the “imported” cases should not impact Africa’s certification as wild poliovirus free, and that “any child paralyzed from polio is one too many.”

COVID lockdowns impacted polio response 

Polio vaccination campaign in Malawi 2022

COVID-19 negatively impacted Africa’s polio response, said Dr Chris Elias, Polio Oversight Board Chair of the Gates Foundation, speaking at the meeting. By putting polio experts at the service of the COVID-19 response, the virus had time to spread. 

“Dozens of campaigns delayed, not only for polio but for measles and other diseases,” he said. “We need good quality routine immunization, campaigns and surveillance. Unfortunately, COVID-19 presented a huge challenge that gave polio time and freedom to act quickly.”

Regarding wild polio, Ouma told Health Policy Watch that any presence of wild polio anywhere in the world poses a huge risk to the achievement that Africa recorded in eradicating the disease.

Ouma called for more efforts to boost polio vaccination across the continent.

“We need to put in place surveillance mechanisms that will be able to respond quickly when a case is identified,” he said. “It is our position that polio is not a regional or a country problem. It remains a global problem.”

New regional health security strategy calls for 90% rapid response capacity by 2030

WHO Regional Committee meeting for Africa

At the WHO Regional Committee meeting, African health ministers adopted a new eight-year strategy to transform health security and emergency response. 

Called the Regional Strategy for Health Security and Emergencies 2022–2030, it is intended to reduce the health and socioeconomic impacts of public health emergencies.

The strategy includes goals for strengthening mechanisms for partnerships and multisectoral collaboration; ensuring sustained and predictable investment; and repurposing resources from polio eradication and COVID-19 to support strategic investments in systems and tools for public health emergencies.

The adoption of the strategy means WHO’s member nations have now agreed to reach 12 strategy targets by 2030 – all aimed at strengthening capacity to prevent, prepare for, detect and respond to health emergencies. 

The strategy calls for 80% of member nations to have “predictable and sustainable” health security financing by 2030, with 90% able to mobilize an effective response to public health emergencies within 24 hours of detection. 

“This strategy is the fruit of extensive consultations with African health ministries and a range of other institutions, technical actors and partners across the continent. With their ongoing support and collaboration, it can help ensure that Africa is at the forefront of protecting the world against future pandemics,” Moeti said.

Image Credits: WHO Africa.

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