Mpox Vaccines Delayed in Congo Amid Escalating Outbreak

The Democratic Republic of Congo is facing a rapidly worsening mpox outbreak, yet vaccines intended to curb the spread may not be available for several months. This delay comes despite the Africa Centres for Disease Control and Prevention (CDC) declaring a public health emergency of continental concern earlier this week. The World Health Organisation (WHO) is also considering declaring the outbreak a global threat, as a panel meets to discuss the situation.

Challenges in Vaccine Distribution: While the declaration of an emergency is intended to galvanize global action, significant obstacles remain. These include limited vaccine supplies, inadequate funding, and the competition from other disease outbreaks. Jean-Jacques Muyembe-Tamfum, head of Congo's Institut National pour la Recherche Biomedicale (INRB), emphasized the need for more funding and support to enhance surveillance and vaccine access. However, he acknowledged the difficulty of implementing these measures in a country already burdened by conflict and other health crises, such as measles and cholera.

Current State of Vaccine Availability: Africa CDC has secured $10.4 million in emergency funding from the African Union for the mpox response, and there are plans to obtain 3 million doses of the vaccine this year. However, sources involved in planning the vaccine rollout in Congo report that only 65,000 doses are expected to be available in the near future. Vaccination campaigns are unlikely to begin before October, at the earliest.

Impact of the Outbreak: This year alone, Africa has reported over 15,000 suspected cases of mpox, resulting in 461 deaths, the majority of which occurred among children in Congo. The viral infection, while typically mild, can be fatal and is characterized by flu-like symptoms and pus-filled lesions. A new strain of the virus has exacerbated the situation, leading to outbreaks in refugee camps in eastern Congo and spreading to neighboring countries such as Uganda, Burundi, Rwanda, and Kenya for the first time.

Global Response and Historical Context: Previous global outbreaks of mpox, particularly among men who have sex with men, prompted WHO to declare a global emergency in 2022. Two vaccines, Bavarian Nordic's Jynneos and LC16 by KM Biologics, were utilized during that outbreak. However, these vaccines have never been accessible in Congo or throughout Africa, where the disease has been endemic for decades. Only LC16 has been approved for use in children.

Despite Congo's regulatory approval of these vaccines in June, the government has yet to formally request doses from manufacturers or potential donors, such as the United States, through the global vaccine group Gavi.

The delay in vaccine distribution continues to be a significant concern as the outbreak worsens, with health experts urging faster action to prevent further loss of life.