Mpox Chronicles: Lessons Echoed from COVID-19 -Md Masud Rana

In light of the recent outbreak of mpox across several African countries, as well as its emergence in Europe and other global regions, the World Health Organisation (WHO) has taken the significant step of declaring a global emergency. This decision reflects the urgency and severity of the situation, as mpox is highly contagious and potentially fatal. However, the true wisdom of this declaration will only become clear in retrospect as we assess its impact on containment efforts, public health measures, and international cooperation. The declaration of a global emergency by the WHO signifies the need for immediate action and coordination among countries to prevent further spread of the disease. It also highlights the importance of investing in research and development of vaccines and treatments for mpox. Ultimately, the effectiveness of this decision will depend on the response of governments, healthcare systems, and the global community in working together to combat this deadly virus.

Monkeypox, previously known as mpox, behaves much like its notorious cousin, the COVID-19 virus. It primarily spreads through close human-to-human contact, but it doesn’t stop there. Contact with animals or their waste, and even consuming undercooked contaminated meat (often referred to as ‘bushmeat’), can also transmit the disease. While monkeypox has historically been endemic in Central Africa, recent trends have raised concerns. A decline in immunity—once bolstered by smallpox vaccinations—may be contributing to the surge in cases. The World Health Organisation (WHO) has taken notice, sounding the alarm to prevent further spread.

Lessons from COVID-19: A Prudent Approach to Preparedness

The European Centre for Disease Prevention and Control has cautiously assessed the risk of a global mpox outbreak as currently low. This time, the World Health Organisation (WHO), which faced severe criticism for its delayed response to COVID-19 five years ago, appears to have adopted a better-safe-than-sorry stance. COVID-19 has been a stern teacher, revealing numerous pitfalls. It is crucial for the WHO, governments, and businesses worldwide to learn from the missteps of the past pandemic and avoid repeating them—even when faced with internal or external pressures to implement certain measures.

Analysing the Emergence of Mpox: A Global Health Concern

The recent emergence of mpox as a potential global threat bears striking similarities to the early days of the COVID-19 pandemic. As we navigate this new challenge, it is crucial that governments and stakeholders draw from the lessons learnt during the pandemic.

One key lesson is the importance of ensuring widespread access to essential medicines, particularly vaccines. While mpox vaccines have existed for years, their availability remains limited, especially in African countries. Unlike the large-scale COVID-19 vaccination campaigns, mpox inoculations have not reached the same level of accessibility.

As we confront this evolving situation, proactive measures are essential. Collaborative efforts between health authorities, regional institutions, and partners can bolster laboratory diagnosis, disease surveillance, and response actions. By learning from past experiences, we can better prepare for the containment and management of mpox outbreaks. While it is important to learn from past experiences, it is also crucial to acknowledge the unique challenges and circumstances surrounding each disease outbreak. Simply relying on past strategies may not be sufficient in addressing the current limitations in mpox vaccine availability.

The Challenges of Vaccination in Africa

The cost of vaccination remains a significant barrier, with each dose priced at $100. To achieve full immunisation, two doses are required per person. Recent estimates indicate that Africa would need to allocate over $4 billion to procure vaccines and inoculate the most vulnerable populations.

However, financial constraints are not the sole hurdle. Even if African nations manage to secure funding for vaccination campaigns, they face another critical issue: vaccine availability. Presently, only one company—Nordic A/S—possesses substantial production capacity. Unfortunately, Nordic A/S has communicated that it cannot meet Africa’s immunisation demands until a year after orders are placed. This delay poses a considerable challenge for timely vaccine distribution across the continent.

Africa grapples with both financial constraints and supply limitations, making widespread vaccination a complex endeavor. Addressing these challenges requires strategic planning, international cooperation, and innovative solutions to ensure equitable access to life-saving vaccines. While Nordic A/S may have significant production capacity, their inability to meet Africa’s immunisation demands in a timely manner raises concerns about their ability to effectively support global health initiatives. Delaying vaccine distribution in Africa could have serious consequences for public health and hinder efforts to combat infectious diseases on the continent.

The Global Vaccine Disparities During the COVID-19 Pandemic

The COVID-19 pandemic exposed stark disparities in vaccine availability and distribution worldwide. Initially, vaccines were scarce, and even when they became available, the production and distribution capacity remained skewed, favouring wealthier nations. This near-monopoly by affluent countries perpetuated inequities, leaving many vulnerable populations without access to life-saving vaccines.

India, often hailed as the “pharmacy of the world,” faced its own challenges. Despite its robust pharmaceutical industry, the country grappled with vaccine shortages for nearly two years. It wasn’t until late 2021 that Indian pharmaceutical firms scaled up production sufficiently to meet domestic demand and contribute to global vaccination efforts. This scenario underscores the urgent need for equitable vaccine distribution, collaborative efforts, and a reevaluation of global health priorities. As we navigate future health crises, addressing these disparities remains paramount.

In the not-so-distant past, African nations found themselves at the tail end of the vaccine distribution queue. It wasn’t until mid-2022 or later that they gained access to these life-saving doses. Meanwhile, in wealthier countries, citizens had already received multiple shots, and governments hoarded vast vaccine stockpiles, reluctant to share with those in need. The result? A stark display of global inequity as vaccines languished in rich countries’ warehouses, eventually expiring and going to waste.

Now, as we confront the threat of mpox, the world must heed the lessons learnt during the COVID-19 pandemic. It’s time for a more compassionate approach. Wealthy nations should promptly share their existing vaccine supplies, ensuring that fatalities are minimised and equitable access prevails. This isn’t just a matter of morality; it’s a strategic imperative for our interconnected planet.

The Global Response to Mpox and Big Pharma’s Role

In the ongoing battle against the mpox virus, there are critical actions that affluent nations can take to address the crisis. One such action involves exerting substantial pressure on pharmaceutical giants—the very companies that reaped unprecedented profits during the COVID-19 pandemic due to massive vaccine orders. Rather than fixating solely on financial gains and shareholder returns, these corporations must shift their focus to the human lives profoundly affected by their profit-driven practices.

A pivotal step is urging Big Pharma firms to sell mpox vaccines at cost, thereby ensuring affordability and accessibility. Additionally, sharing intellectual property rights with generic manufacturers would facilitate global production scale-up. By doing so, we can bolster vaccine availability and distribution, especially in regions where mpox is still emerging.

Africa, where the disease has recently surfaced, presents a unique opportunity. If swift and comprehensive vaccination efforts are implemented, there’s a chance to contain mpox within the continent’s borders and potentially eradicate it altogether. However, time is of the essence, and concerted international cooperation is essential to achieve this goal.

In the wake of the ongoing global health crisis, it is crucial for governments and international organisations to avoid hasty decisions such as imposing widespread lockdowns or severing transportation links. The previous pandemic demonstrated that such measures disproportionately affected vulnerable populations, exacerbating poverty and hindering recovery. As we face the potential threat of a new outbreak, leaders must exercise caution and refrain from repeating past mistakes.

Recognising the limitations of lockdowns, we must seek alternative strategies to mitigate the impact of any emerging infectious disease. While the severity of the hypothetical “mpox” remains uncertain, it is essential to prioritise targeted interventions that protect both public health and socioeconomic stability. Failure to learn from the missteps of the past would be a disservice to humanity, and leaders must approach this challenge with foresight and evidence-based decision-making. As we navigate the potential threat of “mpox,” it is crucial for leaders to prioritise collaboration and information sharing among countries to effectively combat the spread of the disease. Implementing early detection systems and investing in research and development for vaccines and treatments will be key in preventing a widespread outbreak. By learning from the lessons of previous pandemics, we can better prepare for and respond to future health crises, ensuring the well-being of global populations. It is imperative that leaders take decisive action now to protect the health and safety of their citizens and prevent the devastating consequences of a new infectious disease outbreak.