South Africa will once again scramble to purchase Mpox vaccines amid “vaccine apartheid” as President Cyril Ramaphosa at the weekend urged the international community, partners, and organisations to mobilise stockpiles of vaccines and other medical countermeasures for deployment in Africa amid an outbreak of the disease.

This mobilisation needs to be coordinated via the mechanisms established by Africa Africa Centres for Disease Control (CDC) and Prevention to ensure equitable distribution, transparency, and coordination.

Mpox is a viral infection characterised by painful lesions. It is spread by direct contact with an infected person, animal or contaminated items like clothing or bedding.

Ramaphosa, speaking in his role as the African Union (AU) Champion on Pandemic Prevention, Preparedness, and Response, said in a statement on Saturday that Africa required robust support in funding, research, and the sharing of technologies, with financial contributions directed to the Africa Epidemic Fund under the leadership of Africa CDC.

“This is also an opportunity to call on the international community to finalise a fair and equitable Pandemic Agreement – a duty that must be pursued with urgency and a spirit of equity. By fostering global partnerships, we can accelerate Africa’s response and ensure that all nations, regardless of their economic status have fair access to the resources needed to protect their populations,” he said.

On Friday, the World Health Organization (WHO) called for ramped-up vaccine manufacturing production.

“We do need the manufacturers to really scale up so that we’ve got access to many, many more vaccines,” WHO spokesperson Margaret Harris said, AFP reported.

There are two subtypes of the virus: the more virulent and deadlier Clade 1, endemic in the Congo Basin in Central Africa; and Clade 2, endemic in West Africa.

Harris said there were 500 000 MVA-BN doses in stock, while an additional 2.4 million doses could be produced quickly, if there was a commitment from buyers.

For 2025, an additional 10 million doses could be produced, upon a firm procurement request.

The share price of a number of international healthcare and pharmaceutical companies worldwide rose on Friday after the Who declared the rapidly-spreading Mpox outbreak in Africa a public health emergency.

Bavarian Nordic, a vaccine manufacturer based in Denmark, whose Mpox vaccine, Jynneos – also known by the brand names Imvamune or Imvanex – has already been approved. The company’s shares jumped about 17.6% on Friday morning, according to euronews. Other pharmaceutical companies’ shares were also boosted as a result.

However, African and South African pharmaceutical manufacturers are still out in the cold on getting enough international support to produce vaccines locally.

In interview on Friday Dr Stavros Nicolaou, Aspen Pharmacare Group’s senior executive responsible for Strategic Trade Development and who is also the chairperson of Pharmaceuticals Manufactured in South Africa, revealed that there were major international hurdles to overcome before Africa and South Africa would be able to produce vaccines locally, among them guaranteed off-take deals.

“The single biggest thing to get right is for international agencies to start procuring vaccines from Africa. There’s three thing that need to be done now: first technology transfers, second, the reform of the procurement mechanism of procurement agencies and guaranteed off takes for Africa, which will change the picture completely.”

This means Africa and South Africa have to buy vaccines from other countries.

However, Nicolaou, said Africa and South Africa would once more be on the back foot purchasing Mpox vaccines as “vaccine aparheid” was in play.

“But where will South Africa get the vaccine? For example, India will predatory price. They will be in the market much quicker than South Africa,” he said.

Nicolaou said the other problem was that Africa in itself hadn’t set up a pool procurement mechanism to buy vaccines, but the African Union was in the middle of trying to doing so.

According to Dr Jean Kaseya, the director-general of the Africa Centres for Disease Control and Prevention, “Africa needs 10 million Mpox doses and we can only get 200 000,” he said.

Nicolaou said, “The outrage is that after Covid-19 you would never think this would be repeated. Now we’re seeing this repeat before our very eyes again, but it’s happening right now. It’s like déjà vu. A nightmare…”

He said Mpox was particularly problematic for Africa because due to HIV/Aids Africa carried the most immuno-suppressed population. This means the likelihood of your mortality and morbidity going up is much more than, for example, in Europe.

“That is why it is so important to get vaccines here. Although we have a milder strain in South Africa, in Africa the other strain is crossing borders into South Africa,” he warned.

Nicolaou said,“ It feels almost like the early days of HIV. I’m not saying it’s going to be as big as HIV, but the fact is you have an immuno-compromised population. There is treatment for it, but the best treatment is to vaccinate and prevent it in the first place.”

Linda-Gail Bekker, a professor of medicine and chief operating officer of the Desmond Tutu HIV Foundation, supported the call for the need for vaccines to curtail the current outbreak.

She said, “It is important to clarify that the concern about more severe outcomes in immune-compromised people is seen with Clade 2, which is the circulating Clade seen in South Africa and was part of the 2022/23 outbreak… We are obviously concerned as an association.”

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