MSF Responds to WHO Declaring Mpox a Public Health Emergency of International Concern

According to Médecins Sans Frontières/Doctors Without Borders (MSF), on 13 August 2024, the Africa CDC declared the mpox outbreak a Public Health Emergency of Continental Security; MSF recognised the Africa CDC’s declaration and were relieved that the World Health Organization (WHO) on 14 August declared the upsurge of mpox in the Democratic Republic of Congo (DRC) and a growing number of African countries a public health emergency of international concern (PHEIC).

In a statement, MSF strongly supports WHO’s appeal to donors to make the necessary funds available for a comprehensive and coordinated response to the ongoing outbreak covering all components of an outbreak response, including surveillance, building laboratory capacity, community sensitisation and engagement, and guaranteeing peoples’ access to treatments, vaccines and diagnostics.

Although all components of an outbreak response are needed, they have stated that access and use of existing vaccines can be dramatically improved with the following concrete actions:
• WHO should accelerate the Emergency Use Listing (EUL) Procedure of the two mpox vaccines already approved by WHO-listed national regulatory authorities. EUL will encourage manufacturers to increase their production of the mpox vaccines, and allow Gavi, The Vaccine Alliance and UNICEF to procure these vaccines for distribution.
• With Africa CDC Director General Kaseya having estimated that at least 10 million doses of mpox vaccines will be needed to respond to the ongoing epidemic, countries that are in possession of substantial stockpiles of MVA-BN vaccines*, and that are not experiencing any active outbreaks, must donate as many doses as possible for allocation to affected countries in Africa.
• All relevant parties must find a legal arrangement for any compensation that stems from the use of the MVA-BN vaccine in children and adolescents during this outbreak, such as a no-fault compensation fund. The paediatric use of MVA-BN was recommended by the United States CDC during the 2022 mpox outbreak and by the WHO Strategic Advisory Group of Experts on Immunization (SAGE) among children with increased risk of contracting mpox.
• The current price of the MVA-BN vaccine is out of reach for most low- and middle-income countries (LMICs) where mpox is endemic or is currently spreading. Bavarian Nordic must review its pricing policy, and urgently seek partnership with one of the emerging vaccine manufacturers in Africa for a full and timely tech transfer so a vaccine protecting against a disease that is endemic to Africa can also be produced on the African continent in the future.

“The extremely limited availability of mpox vaccines in DRC has already drastically reduced the reach of the national strategic plan for vaccination against mpox,” said Dr Justin B. Eyong, Intersectional Epidemiological Coordinator for MSF in DRC. “This means that without improved access to vaccines, thousands of people, including children under 15 years old who are particularly affected by mpox (representing 56% and 79% of all cases and deaths from mpox in 2024, respectively), may be left unprotected. With the mpox outbreak in DRC continuing to evolve rapidly, the situation is urgent, and every necessary step must be taken to get mpox vaccines to the adults and children who need them now.”

Luxembourg

Dr Amrish Baidjoe, Director of MSF's operational research unit in Luxembourg (LuxOR), epidemiologist and microbiologist, stated: “We are currently seeing an escalation of outbreaks of Mpox in several countries on the African continent. Mpox has been endemic in several countries on the African continent but the current number of outbreaks and confirmed cases is unprecedented. There are several variants circulating but at this moment it is not clear how exactly the impact of these variants differs. We are seeing a large number of cases in the Republic of Congo but also observe outbreaks in other countries where we didn’t observe these before and where MSF has operations."

He continued "There is a vaccine that protects relatively well against disease but it is not widely available. This is particularly important for risk groups such as people who are immunocompromised (such as HIV/AIDS patients), children, pregnant women and the elderly. In addition to making vaccines more widely available, it is also important that diagnostic tools are made more widely available so that we can better diagnose but also better monitor the continuation of these outbreaks. Following the many lessons we have learned from COVID, it is important that the international community follows through on its promises to make vaccines and diagnostic tools more widely available."

He concluded: "Within the current medical projects, MSF is working with local partners on different elements of the response looking at how we can better manage and treat patients and, work with communities and staff on preventive methods and health education that is not stigmatising. We are also looking at how we can improve our data collection and surveillance to better understand trends in these outbreaks as well as to understand the disease better through potential research in the future.”