DRC Receives First Mpox Vaccine Shipment as Outbreak Accelerates Across Africa

The Democratic Republic of the Congo (DRC) has received its first significant shipment of mpox vaccines, an essential step in addressing the ongoing outbreak of the virus that has surged across Africa this year. The donation of nearly 100,000 doses, delivered to Kinshasa as part of a European Union initiative, marks a crucial intervention, particularly as health officials warn that millions more doses will be necessary to effectively curb the spread of the disease. Dr. Jean Kaseya, the director general of the Africa Centres for Disease Control and Prevention (Africa CDC), cautioned that the outbreak is accelerating at an alarming rate. "The outbreak is really moving [fast]," Kaseya stressed, highlighting the urgency of the situation. As of now, Africa has reported almost 25,000 cases of mpox in 2023, with 5,549 confirmed through testing and a tragic death toll of 643. The DRC continues to bear the brunt of the outbreak, accounting for the majority of the cases, but there is a growing concern as infections rise in other regions. A particularly worrying development has emerged with the identification of a case in a seven-year-old child in Guinea, potentially indicating the first instance of the new clade Ib variant in West Africa. This mutated form of the virus, first detected in eastern DRC, is believed to spread through close contact, contributing to the notable increase in reported cases. The World Health Organization (WHO) and African health officials have declared the outbreak a public health emergency, underscoring the need for a robust response plan estimated to cost nearly $600 million over the next six months. While about 380,000 doses of mpox vaccines have been pledged by Western partners, including the EU and the U.S., health officials estimate that at least 3 million doses will be necessary to effectively end outbreaks in the DRC. The vaccination initiative will prioritize individuals who have been in contact with suspected cases, as well as healthcare workers and frontline staff in areas experiencing active transmission. Unfortunately, the rollout of this vaccine program may not commence until October at the earliest, as local healthcare workers are still undergoing training on vaccine storage and administration. In addition, a public information campaign is being organized to enhance awareness of mpox and address growing vaccine hesitancy. Most of the mpox cases reported in the DRC involve children, a demographic that has not yet been approved for vaccination. Although regulators are reviewing data that could lead to the vaccine being authorized for adolescents aged 12 to 17 by the end of the month, any approval for younger children is anticipated to take longer. Concerns about the affordability of the vaccine have been raised, with estimates from WHO indicating costs between $50 to $75 per dose. Dr. Andrew Hill from Liverpool University emphasized the need for Bavarian Nordic, the vaccine manufacturer, to reduce prices or permit a generic company to produce the vaccine at lower costs, particularly in light of the scale of orders required for Africa. In response, a Bavarian Nordic spokesperson indicated that while the company is pleased that their vaccine is being delivered to aid the people of Africa, they expressed concern over speculation regarding pricing, noting that no official pricing discussions have taken place. The company has previously indicated a willingness to explore a tiered pricing model for countries with limited resources or those placing larger, long-term orders. Adding to the urgency of the situation, clade Ib has recently been reported in Kinshasa, with Dr. Eddy Lusamaki from the DRC's National Institute of Biomedical Research warning that its presence in the capital city, which has numerous international connections, necessitates strengthened surveillance strategies to mitigate the disease's spread. As the DRC grapples with this health crisis, the coming weeks will be crucial in determining the trajectory of the outbreak and the effectiveness of the introduced vaccination efforts.