Despite the Infections, Africa Without Monkeypox Vaccines

By Kestér Kenn Klomegâh

The World Health Organization (WHO) has declared monkeypox a new global health emergency after 20,000 cases were reported in 77 countries. Some 75 people have died in the 11 African countries where the disease was recorded, according to the latest reports in late July. It said monkeypox is an “extraordinary” situation that qualifies as a global health emergency.

Despite these few deaths last month and signs that it would spread further, Africa is fighting monkeypox without vaccine the same as it has been with Covid-19. A surge in monkeypox infections has particularly been reported since early May outside the West and Central African countries where the disease has long been endemic.

The vast majority of deaths due to monkeypox have been registered on the African continent. Africa remains the only part of the world with no doses of the vaccine, according to the Africa Centers for Disease Control and Prevention.

“Let us get vaccines onto the continent,” acting head of the African Centre for Disease Control, ACDC, Ahmed Ogwell, said in a weekly media briefing pointing to another instance of 1.3 billion people on the continent without access to a vaccine, as in the Covid-19 pandemic.

Reports said that monkeypox has been established in parts of central and west Africa for decades, but it was not known to spark large outbreaks beyond the continent or to spread widely among people until May when authorities detected dozens of epidemics in Europe, North America and elsewhere.

Ogwell said the Africa CDC has engaged with international partners in attempts to obtain vaccines, and while he said “good news” is expected in the coming days, “we cannot be able to give you a timeline.”

Even doses of the smallpox vaccine, which has shown effectiveness against monkeypox, are not available in Africa, Ogwell said. “The solutions need to be global in nature,” he said, in a warning to the international community. “If we’re not safe, the rest of the world is not safe.”

The Covid-19 pandemic and the global hoarding of vaccine doses were a jolt to African leaders, who quickly joined together in an unprecedented effort to obtain doses and establish the production of more vaccines on the continent.

WHO’s Director-General Tedros Adhanom Ghebreyesus said there were about 16 million doses of approved vaccine available, but only in bulk, so it would take several months to get them into vials. His organization is currently urging countries with stockpiles to share vaccines while supply is constrained. It, however, estimates that between 5 million and 10 million doses of vaccine will be needed to protect all high-risk groups.

It has said it is creating a vaccine-sharing mechanism for protection against monkeypox, but the organization has released few details, so there’s no guarantee that African countries will get priority. No countries have yet agreed to share any vaccines with the health organization.

WHO, however, warned against discrimination. “A failure to act will have grave consequences for global health,” Lawrence Gostin, the director of the WHO Collaborating Center on National and Global Health Law, said on Twitter.

Health officials have emphasized that monkeypox can infect anyone in close contact with a patient or their contaminated clothing or bedsheets. Researchers are still exploring how it spreads but believe it’s mainly through close, skin-to-skin contact and through contact with bedding and clothing that touched an infected person’s rash or body fluids.

Another report also pointed to the fact that monkeypox has been a globally neglected public health problem in parts of Africa for decades, but cases began to be reported outside countries where it is endemic in May. It generally causes mild to moderate symptoms, including fever, fatigue and painful skin lesions that resolve within a few weeks.

In Africa, monkeypox mainly spreads to people by infected wild animals like rodents in limited outbreaks that typically have not crossed borders. In Europe, North America and elsewhere, however, monkeypox is spreading among people with no links to animals or recent travel to Africa. In the U.S. and Europe, the vast majority of infections have happened in men who have sex with men, though health officials have stressed that anyone can contract the virus.