In race for monkeypox vaccines, experts see repeat of COVID

Moves by rich countries to buy large quantities of monkeypox vaccine, while declining to share doses with Africa, could leave millions of people unprotected against a more dangerous version of the disease and risk continued spillovers of the virus into humans, public health officials are warning.

Critics fear a repeat of the catastrophic inequity problems seen during the coronavirus pandemic.

“The mistakes we saw during the COVID-19 pandemic are already being repeated,” said Dr. Boghuma Kabisen Titanji, an assistant professor of medicine at Emory University.

While rich countries have ordered millions of vaccines to stop monkeypox within their borders, none have announced plans to share doses with Africa, where a more lethal form of monkeypox is spreading than in the West.

To date, there have been more than 22,000 monkeypox cases reported in nearly 80 countries since May, with about 75 suspected deaths in Africa, mostly in Nigeria and Congo. On Friday, Brazil and Spain reported deaths linked to monkeypox, the first reported outside Africa. Spain reported a second monkeypox death Saturday.

“The African countries dealing with monkeypox outbreaks for decades have been relegated to a footnote in conversations about the global response,” Titanji said.

Scientists say that, unlike campaigns to stop COVID-19, mass vaccinations against monkeypox won’t be necessary. They think targeted use of the available doses, along with other measures, could shut down the expanding epidemics that were recently designated by the World Health Organization as a global health emergency.

Yet while monkeypox is much harder to spread than COVID-19, experts warn if the disease spills over into general populations — currently in Europe and North America it is circulating almost exclusively among gay and bisexual men — the need for vaccines could intensify, especially if the virus becomes entrenched in new regions.

On Thursday, the Africa Centers for Disease Control and Prevention called for the continent to be prioritized for vaccines, saying it was again being left behind.

“If we’re not safe, the rest of the world is not safe,” said Africa CDC’s acting director, Ahmed Ogwell.

Although monkeypox has been endemic in parts of Africa for decades, it mostly jumps into people from infected wild animals and has not typically spread very far beyond the continent.

Experts suspect the monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease started spreading via sex at two raves in Spain and Belgium. Currently, more than 70% of the world’s monkeypox cases are in Europe, and 98% are in men who have sex with men.