Dr Javier Guzman, director of global health policy at the Center for Global Development, said most wealthy countries have enough doses stored to share mpox shots from smallpox vaccine reserves while protecting national security.
“For instance, Japan has a stockpile of around 200 million doses of the LC16 vaccine. Donating just three million doses, as Japan has done, marginally reduces their reserves. Similarly, Spain has pledged 500,000 doses, approximately 20 per cent of its mpox vaccine stockpile,” he said.
“If more high-income countries take similar steps, they significantly increase the chances of containment, reducing the need for African countries to wait for new vaccine manufacturing.”
Dr Guzman also reiterated that it would be a “mistake” to overlook the current threat posed by a more lethal strain which is already spreading widely.
“When high-income countries conduct their risk-benefit analysis, they should consider that the risk of smallpox in high-income countries is very low, according to WHO, despite concerns about the possibility of deliberate release. In contrast, the risk of mpox spreading further is a real and present threat.”
However, limited donations are not the only reason the rollout of mpox shots has been slow.
“We have a real challenge in the world right now around access to medical countermeasures,” said Prof Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center.
“It happens for a lot of reasons – it’s everything from national security implications, to the cost of production, to the legal and regulatory barriers, to getting the product to the right populations. And none of these have easy solutions attached to them.”
In this outbreak, regulatory issues have hit the headlines. It was only on September 13 that the WHO authorised the first shot for mpox, made by Bavarian Nordic, in a process called pre-qualification.
This is significant for two reasons. First, because many low and middle income countries without strong regulators also rely on the WHO to determine which medical tools are safe and effective – although, in the case of the DRC, the country gave two mpox vaccines the green light in late June.
Second and perhaps more importantly, UN agencies and Gavi require the WHO approval to buy and distribute shots. Which is why Gavi only last Wednesday announced its first purchase of Bavarian Nordic mpox shots for use in this outbreak.
