Africans see inequity in monkeypox response

OSUN, Nigeria (AP):

As health authorities in Europe and elsewhere roll out vaccines and drugs to stamp out the biggest monkeypox outbreak beyond Africa, some doctors acknowledge an ugly reality: The resources to slow the disease’s spread have long been available, just not to the Africans who have dealt with it for decades.

Countries including Britain, Spain, Portugal, Italy, Switzerland, the United States, Israel and Australia have reported more than 500 monkeypox cases, many apparently tied to sexual activity at two recent raves in Europe. No deaths have been reported.

Authorities in numerous European countries and the US are offering to immunise people and considering the use of antivirals. On Thursday, the World Health Organization (WHO) will convene a special meeting to discuss monkeypox research priorities and related issues.

Meanwhile, the African continent has reported about three times as many cases this year.

There have been more than 1,400 monkeypox cases and 63 deaths in four countries where the disease is endemic – Cameroon, Central African Republic, Congo and Nigeria – according to the Africa Centers for Disease Control and Prevention. So far, sequencing has not yet shown any direct link to the outbreak outside Africa, health officials say.

Monkeypox is in the same family of viruses as smallpox, and smallpox vaccines are estimated to be about 85 per cent effective against monkeypox, according to WHO.

Since identifying cases earlier this month, Britain has vaccinated more than 1,000 people at risk of contracting the virus and bought 20,000 more doses. European Union officials are in talks to buy more smallpox vaccine from Bavarian Nordic, the maker of the only such vaccine licensed in Europe.

US government officials have released about 700 doses of vaccine to states where cases were reported.

Such measures aren’t routinely employed in Africa.

Dr Adesola Yinka-Ogunleye, who leads Nigeria’s monkeypox working group, said there are currently no vaccines or antivirals being used against monkeypox in her country. People suspected of having monkeypox are isolated and treated conservatively, while their contacts are monitored, she said.

Generally, Africa has only had “small stockpiles” of smallpox vaccine to offer health workers when monkeypox outbreaks happen, said Ahmed Ogwell, acting director of the Africa CDC.

Limited vaccine supply and competing health priorities have meant that immunisation against monkeypox hasn’t been widely pursued in Africa, said Dr Jimmy Whitworth, a professor of international public health at the London School of Hygiene and Tropical Medicine.

“It’s a bit uncomfortable that we have a different attitude to the kinds of resources we deploy depending on where cases are,” he said. “It exposes a moral failing when those interventions aren’t available for the millions of people in Africa who need them.”

WHO has 31 million doses of smallpox vaccines, mostly kept in donor countries and intended as a rapid response to any re-emergence of the disease, which was declared eradicated in 1980. Doses from the UN health agency’s stockpile have never been released for any monkeypox outbreaks in central or western Africa.