Africa Launches Single Mpox Response Plan As DRC Prepares To Get Vaccine Donations To Hotspots

Now that the first mpox vaccines have arrived in the Democratic Republic of Congo (DRC) courtesy of a European Union donation, the challenge is to ensure that they get to where they are needed most.

This includes war-torn eastern DRC, camps of displaced people in North and South Kivu, and the immediate family members of those with mpox, particularly parents and siblings of infected children – an estimated 60%-plus cases in the DRC.

The Africa Centres for Disease Control and Prevention (Africa CDC) and United Nations Children’s Fund (UNICEF) announced the arrival of 99,100 doses of Bavarian Nordic’s Jynneous (MVA-BN) vaccine on Thursday.

The DRC, the epicentre of the outbreak, declared mpox an epidemic over 18 months ago but its drug regulator only authorised the emergency use of the two mpox vaccines – Jynneous and Japan-based KM Biologics’ LC16 vaccine – in late June.

The World Health Organization (WHO) is currently reviewing Jynneous and LC16 for emergency use listing (EUL). Had it moved to do so sooner, the DRC and other affected areas would have been able to use this to get the vaccine.

Africa CDC Director General Dr Jean Kaseya told a Friday media briefing that the drug regulators in Rwanda, Cameroon and Nigeria had now issued EULs for Jynneous, which enabled them to also receive vaccine donations.

“We are expecting the [EUL] form from Burundi very soon,” added Kaseya of the country with the second highest toll, which is also one of the poorest countries in the world with very weak infrastructure.

Jynneous is not listed for use in children. However, WHO’s Dr Ana-Maria Restrepo told a briefing on Wednesday that countries would be able to use it off-label for children.

Mpox cases continue to rise

Mpox cases continue to rise in the continent with 5,466 suspected new cases (252 confirmed) and 26 deaths in the past week, according to Kaseya.

“Displaced families living in crowded schools, churches and tents in farmers’ fields have no space to isolate when they develop symptoms of the disease,” warned the UN High Commission for Refugees(UNHCR).

“UNHCR staff have found some affected individuals trying diligently to follow preventive measures and protect their communities by sleeping outside.  A balanced diet is also important for recovery, a reality out of reach for many of the displaced who subsist on meagre food rations.”

The UNHCR also noted that, while rapid testing of suspected cases is critical, “in unstable zones of the eastern DRC, the security risks and circuitous routes necessary to get samples to a laboratory mean delays, hence test results cannot be used effectively to break transmission chains”.

One African response plan

In response to the outbreaks, Africa CDC and WHO Africa have devised a joint continental response plan to ensure a coordinated approach to the outbreaks.

According to the plan’s foreword, the COVID-19 pandemic exposed “vulnerabilities in our health systems, showed Africa’s inequity and unfair treatment in terms of access to medical countermeasures, highlighted the urgent need for enhanced preparedness, and underscored the importance of swift, coordinated action in the face of emerging health threats”.

A key lesson learnt was that public health emergencies require “solidarity, resilience, and collaboration”.

In this regard, the continent has resolved to follow a single coordination mechanism, continental response plan, budget, and monitoring and evaluation mechanism.

The plan divides African member states into four categories based on their mpox status and risk level. The highest risk is countries with sustained human-to-human transmission, followed by countries with sporadic human cases since January 2022 or endemic zoonotic reservoirs.

Countries needing enhanced readiness due to their proximity to countries with ongoing transmission are the third category, while the fourth is those who are not currently facing an outbreak or near one.

“The plan includes measures to strengthen surveillance, laboratory detection, case management, infection prevention and control, vaccination, risk communication and community engagement and research and innovation,” according to a joint media release.

Image Credits: WHO.