A scramble for monkeypox vaccines is under way, with 35 countries vying for access to the 16.4m doses that exist so far, according to the World Health Organization (WHO), and a risk that low-income countries may lose out.
Meg Doherty, WHO’s director of Global HIV, Hepatitis and Sexually Transmitted Infections Programmes, said there was “quite a possible risk” that the countries bidding for supplies would be high-income countries.
“We’ll have to watch out for this,” she said. “Our mantra has been and continues to be that we want equity. If WHO needs to say that louder and stronger for those countries who are not getting access, we will continue to do that.
“We can’t have a monkeypox response that’s only responding to the UK, Canada, the United States. We need a response that also addresses what’s happening in the DRC right now; in Nigeria where cases are going up.”
Doherty was speaking at the International Aids conference in Montreal, Canada, where Prof Chris Beyrer from Johns Hopkins University said on Friday that monkeypox was another preventable pandemic, and the warning signs were there five years ago.
“It turns out that monkeypox emerged out of its central African endemic zone into west Africa in 2017, five years ago, and that outbreak has been ongoing for five years with no urgency, no response, no WHO engagement around vaccines in those countries,” said Beyrer, a member of an ongoing Lancet Commission on health and human rights.
He added: “Now that it has gone from six endemic countries to 76, and is the new emerging global health threat in the wealthy world, we have this sense of urgency.”
Doherty said discussions were imminent with Japan, where another vaccine had been developed, and that 100m doses of smallpox vaccines also existed, but “that’s probably the least likely vaccine that most countries want to be using at this point in time, due to potential side-effects”.
Vaccinating all those who need it will take a long time. In Montreal, only a third of the population most at risk, men who have sex with men, have been vaccinated – 20,000 doses out of 60,000 people estimated to be eligible in the city, said Marina Klein, research director of chronic viral illnesses at McGill University.
Latest WHO figures show nearly 20,000 cases of monkeypox in 78 countries, and five deaths. The data shows 98% of those affected are men who have sex with men, but there have been small numbers of cases in women and a couple in children.