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WHO shares vaccines to stop monkeypox amid fears of injustice

LONDON – The World Health Organization said it was creating a new vaccine-sharing mechanism to halt monkeypox outbreaks in more than 30 countries outside of Africa. The move could result in the UN health agency distributing scarce doses of vaccine to rich countries that could otherwise afford them.

For some health experts, the initiative may miss an opportunity to control the monkeypox virus in African countries where it has been infecting people for decades, another example of the inequality in vaccine distribution seen during that time the coronavirus pandemic.

WHO Director-General Tedros Adhanom Ghebreyesus said the agency was developing an initiative for “fair access” to vaccines and treatments, which it hopes will be ready within weeks. The mechanism was proposed shortly after the UK, Canada, France, Germany, the US and other countries reported hundreds of monkeypox cases last month.

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Vaccines against smallpox, a related disease, are believed to be about 85% effective against monkeypox. WHO Europe director Hans Kluge said on Wednesday he was concerned about some rich countries’ scramble to buy more vaccines without talking about buying supplies for Africa.

Kluge urged governments to “tackle monkeypox without repeating the mistakes of the pandemic.” Still, he didn’t rule out the possibility that countries like the UK, which is currently having the largest outbreak outside of Africa, could receive vaccines through the WHO’s mechanism.

He said the program will be made for all countries and vaccines will be distributed largely based on their epidemiological needs.

“Europe remains the epicenter of this escalating outbreak, with 25 countries reporting more than 1,500 cases, or 85% of the global total,” Kluge noted.

Some African experts questioned why the UN health agency has never suggested using vaccines in Central and West Africa, where the disease is endemic.

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“The place to start vaccination should be Africa and not anywhere else,” said Dr. Ahmed Ogwell, acting director of the Africa Centers for Disease Control and Prevention.

He said the lack of monkeypox vaccines on the continent, which has reported more than 1,500 suspected cases and 72 deaths this year, is a more critical problem than the clusters of mostly mild illnesses reported in rich countries.

“This is an extension of the injustice we’ve seen during COVID,” said Dr. Ifeanyi Nsofor, director of policy and advocacy at Nigeria Health Watch. “We’ve had hundreds of cases of monkeypox in Nigeria from 2017 to now and we’re dealing with it on our own,” he said. “No one discussed when there might be vaccines for Africa.”

After the outbreak of the coronavirus pandemic in 2020, global health authorities rushed to establish COVAX, a United Nations-backed COVID-19 vaccine distribution initiative. But rich countries were buying up most of the world’s supply, and the COVAX program missed several goals to share doses with the world’s poor.

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So far, only about 17% of people in poorer countries have received a single dose of the coronavirus vaccine. Some experts fear the same could happen with monkeypox.

“Just like with COVID, there is no clear way poorer countries can get vaccines,” said Brook Baker, a law professor at Northeastern University who specializes in access to medicines.

He warned that rich countries that previously promised doses may not cooperate when the WHO tries to determine how many vaccine doses are available.

“Rich countries will protect themselves while people die in the Global South,” predicted Baker.

On Monday, advocacy group Public Citizen sent a letter to the White House asking if the Biden administration would release the 20 million smallpox vaccines that the US pledged in 2004 for use by the WHO in an emergency, such as a biological attack.

Asked about the commitment, a senior US official said the government is “assessing all options” to advance efforts to combat monkeypox in the US and around the world.

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The official said the US returned more than 200,000 doses of a smallpox vaccine to the manufacturer for use by others. The official declined to say whether the US views the current monkeypox outbreak as an emergency warranting the release of the 20 million vaccines it had promised.

Francois Balloux, an infectious disease expert at University College London, said vaccination efforts in rich countries should lead to an overhaul of future monkeypox control strategies in Africa.

“It really should be a priority to vaccinate people in Africa, where there is a worse strain that has actually killed people,” he said, adding that further transmissions of monkeypox are likely in the future.

“Whatever vaccination happens in Europe will not solve the problem,” Balloux said.

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Zeke Miller in Washington contributed to this report.

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https://www.local10.com/news/world/2022/06/15/who-to-share-vaccines-to-stop-monkeypox-amid-inequity-fears/ WHO shares vaccines to stop monkeypox amid fears of injustice

Sarah Y. Kim

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