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LONDON — The World Health Organization has said it will create a new vaccine-sharing mechanism to curb the outbreak of monkeypox in more than 30 countries beyond Africa. The move could lead the UN health agency to distribute the rare vaccine doses to wealthy countries that could otherwise afford them.
For some health experts, the initiative potentially misses the opportunity to control the monkeypox virus in African countries where it has been infecting people for decades, illustrating again the inequity in vaccine distribution that has been observed during the coronavirus pandemic.
WHO Director-General Tedros Adhanom Ghebreyesus said the agency was developing an initiative for “equitable access” to vaccines and treatments and hoped to have it ready within weeks. The mechanism was proposed shortly after Britain, Canada, France, Germany, the United States and other countries reported hundreds of cases of monkeypox last month.
The WHO described the outbreak as “unusual” and said the continued spread of the virus was worrying enough to convene its expert committee next week to decide whether monkeypox should be declared a global emergency.
Vaccines against smallpox, a related disease, are thought to be about 85% effective against monkeypox. WHO director for Europe Dr Hans Kluge said on Wednesday he was concerned about some wealthy countries scrambling to buy more vaccines, let alone buy some for Africa.
Dr Kluge urged governments “to address monkeypox without repeating the mistakes of the pandemic”. Still, he did not rule out the possibility that countries like Britain, which is currently experiencing the largest outbreak outside Africa, could receive vaccines through the WHO mechanism.
He said the program was being created for all countries and the vaccines would be widely distributed according to their epidemiological needs.
“Europe remains the epicenter of this growing epidemic, with 25 countries reporting more than 1,500 cases, or 85% of the global total,” noted Dr Kluge.
Some African experts have questioned why the UN health agency has never offered to use vaccines in central and western Africa, where the disease is endemic.
“The place to start any vaccination should be Africa and nowhere else,” said Dr Ahmed Ogwell, acting director of the Africa Centers for Disease Control and Prevention.
He added that the lack of vaccines to fight monkeypox on the continent, where more than 1,500 suspected cases and 72 deaths have been reported this year, was a more critical concern than clusters of mainly mild illnesses reported in wealthy countries. .
“This is an extension of the inequity we have seen during COVID,” said Dr Ifeanyi Nsofor, director of policy and advocacy at Nigeria Health Watch. “From 2017 to now, we have had hundreds of cases of monkeypox in Nigeria and we are dealing with them alone,” he said. “No one has discussed when there might be vaccines available for Africa.”
After the coronavirus pandemic exploded in 2020, global health agencies rushed to set up COVAX, a UN-backed effort to distribute COVID-19 vaccines. But rich countries bought most of the world’s supply, and the COVAX program missed several targets to share doses with the world’s poor.
To date, only around 17% of people in poor countries have received a dose of the coronavirus vaccine. Some experts fear the same could happen with monkeypox.
“Just like with COVID, there is no clear path for how poorer countries will be able to get vaccines,” said Brook Baker, a law professor at Northeastern University who specializes in access to vaccines. medications.
He warned that as the WHO tries to work out how many vaccine doses are available, wealthy countries that previously pledged doses may not cooperate.
“Rich countries will protect themselves while people in the South die,” Mr. Baker predicted.
On Monday, advocacy group Public Citizen sent a letter to the White House, asking if the Biden administration would release the 20 million smallpox vaccines the United States promised in 2004 for use by the WHO in emergency, such as a biological attack.
Asked about the pledge, a senior US official said the government was “exploring all options” to continue its efforts to curb monkeypox in the United States and around the world.
The official said the United States had returned more than 200,000 doses of a smallpox vaccine to the manufacturer to make available to others. The official declined to say whether the United States views the current monkeypox outbreak as an emergency that warrants the release of the promised 20 million vaccines.
Francois Balloux, an infectious disease expert at University College London, said vaccination efforts in wealthy countries should prompt a rethinking of future response strategies to monkeypox in Africa.
“It really should be a priority to vaccinate people in Africa, where there is a more virulent strain that has actually killed people,” he said, adding that further impacts from monkeypox were likely.
“Whatever vaccination is going on in Europe, it won’t solve the problem,” Balloux said.
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