CSOs highlight mpox vaccine gaps, call for global support

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KAMPALA - Civil Society Organisations (CSOs) have sounded an urgent alarm over the country's readiness to manage the looming outbreak.

During a stakeholder engagement in Kampala, on September 6, 2024, Henry Magala, the country director of the AIDS Healthcare Foundation, called for immediate action to address vaccine access and distribution.

“Uganda’s exposure is stark. We must fix vaccine access and distribution now to avert disaster,” Magala said, as civil society urged global co-operation to accelerate vaccine availability and improve local infrastructure.

His warning comes amid growing concerns about the spread of mpox from the Democratic Republic of Congo (DRC), where the clade  Ib variant has already infected over 19,900 people and claimed 975 lives.

Uganda, which shares a border with the DRC, has so far confirmed 10 mpox cases. With heavy cross-border traffic, health experts warned that Uganda may face an uncontrollable spread if urgent measures aren’t taken.

Strained vaccine supply

International organisations, including United Nations International Children's Emergency Fund, Gavi, Africa Centres for Disease Control and Prevention (CDC), and the World Health Organisation (WHO), are scrambling to secure up to 12 million vaccine doses for African nations affected by Mpox.

However, Magala said significant hurdles stand in the way of timely distribution:

“Vaccine supply chains are strained, costs are high, and regulatory delays continue to stall the rollout. The Jynneos vaccine, a critical tool in the fight against Mpox, costs approximately $100 (about sh3,700) per dose, a prohibitive price that mirrors the inequities seen during the COVID-19 pandemic”.

CSOs said the high cost of these vaccines is not just an economic issue — it is a matter of life and death: “We have already seen the devastating effects of vaccine inequity during the COVID-19 pandemic where vaccine hoarding by wealthier nations resulted in over 1.3 million preventable deaths, primarily in the Global South".

For instance, Magala noted that by February 2022, only 10.2% of Uganda’s population was fully vaccinated against COVID-19, compared to over 70% in wealthier nations.

“The socio-economic impacts of COVID-19 were felt globally and we risk a similar global shutdown if we do not address mpox with the same urgency and collaboration. Without fixing the distribution mess, Uganda could be the next hotspot as mpox seeps across borders from DR Congo,” Magala said.

His sentiments were echoed by WHO director general Dr Tedros Adhanom Ghebreyesus, who highlighted the global inequities in vaccine distribution.

“The COVID-19 pandemic taught us harsh lessons about vaccine inequality. If we don’t act fast, mpox could spread unchecked from DR Congo into Uganda,” Tedros warned.

He called for affordable vaccines and expedited distribution to prevent another health crisis.

Stuart Ssebibubbu, a researcher from Afya na Haki, an African research and training institution that advances health, human rights, and sexual and reproductive health and rights (SRHR) said the rapid spread across the continent highlights the critical need for a coordinated response.

“We are advocating for streamlined regulatory processes, enhanced funding for supply chains, and real-time data sharing to monitor and respond to outbreaks effectively. DR Congo reportedly received between 100,000 to 200,000 doses six hours ago and it took the country about 18 months to reach this level. This means we need to up our game as Uganda,” he said.

Ssebibubbu added, “Our call to action is clear: we need urgent technology and know-how transfers including patent waivers to enable regional vaccine production. These measures will increase vaccine supply, reduce costs, and strengthen the global response to Mpox.”

Dr. Daniel Kyabayinze (C), the Director of Public Health at Uganda's Ministry of Health, during the engagement.

Health ministry updates

While giving the latest highlights on the pandemic, Dr Daniel Kyabayinze, the director of public health at Uganda's health ministry, during the engagement said the country’s vulnerability due to its geographical proximity to the DRC.

“We have 17 districts that border Congo, with some porous issues, allowing easy movement and transit,” Kyabayinze said. 

He added that while Uganda has swiftly implemented a response plan to contain the virus, the country’s position at the crossroads of the outbreak poses a significant challenge.

“However, we have established transmission chains to contain the pandemic. Currently, Uganda has 10 cases, of which six are active and are being managed,” Kyabayinze said, adding that most of those affected are youths under 40, adding another layer of concern for public health authorities as the younger population seems particularly vulnerable.

Additionally, Kyabayinze said Uganda has taken several steps to mitigate the spread of mpox: “Entebbe Hospital has been designated as the evacuation center for confirmed cases, while a free SMS service has been introduced to enable the public to report suspected case".

In response, Uganda is set to receive 100,000 doses of the mpox vaccine through Africa CDC.

The Government has also launched public health campaigns urging citizens to avoid contact with infected individuals and refrain from sharing personal items, such as beddings, to prevent transmission according to Dr. Kyabayinze.

“So far, no one has died from mpox in Uganda, and we are working tirelessly to keep it that way,” Dr. Kyabayinze said optimistically. He assured the public that the likelihood of fatal outcomes from Mpox is minimal, but continued vigilance is essential.

Prioritise equitable vaccine access for Africa

Philip Okello Apira from the Center for Health, Human Rights & Development (CEHURD), called on global leaders to prioritise equitable vaccine access for Africa, where the healthcare infrastructure often struggles to keep up with emerging infectious diseases.

He added: “Streamline approvals, fund the supply chain, and ramp up real-time data sharing. We cannot afford to sleepwalk into another international health crisis.”

Background

As of September 2024, mpox cases have been confirmed in 18 African countries, including Uganda, Kenya, Nigeria, Ghana, and Cameroon.

Uganda has reported 10 cases and 95 contacts as reported last Wednesday. The country’s two index Mpox cases in July 2024 originated from Kasese district.

In the Democratic Republic of Congo (DRC), the new clade 1b variant has caused over 18,000 cases and claimed 629 lives, according to UNICEF.

Africa CDC estimated the need for 10 million doses of mpox vaccines but only 200,000 are in the pipeline.

Magala said mpox vaccines are stockpiled in developed countries, noting that “this glaring inequity underscores the dire need for immediate and effective intervention for the African continent”.

He added: “It is deeply disturbing that three years after the widespread Mpox outbreak WHO is yet to officially approve the MVA-BN and LC16 vaccines for use in developing countries despite their approval in the US and Europe.”

According to him, this delay in Africa’s access is unacceptable, especially given the recent surge in cases. “While we acknowledge WHO's recent efforts to fast-track approvals through the "Emergency Use Listing" process, this must be finalized swiftly. Africa cannot afford a repeat of the deadly procrastination witnessed during the COVID-19 pandemic,” he noted.

46 contact people under surveillance

Kyabayinze said currently, 46 people in Uganda who had contact with confirmed Mpox cases remain under surveillance.

He said he is hopeful that with swift action, Uganda will contain the virus. “We believe we will defeat Mpox. We’ve learned from past epidemics, and with global cooperation, we can prevent this from becoming a full-blown crisis.”