How little we have learned
As if the Covid-19 pandemic wasn’t enough to contend with, there’s a global monkeypox outbreak too. Since the first case was reported in the United Kingdom in early May, there have been 44,000 further cases in more than 90 countries.
The good news is that monkeypox is a disease we’ve known about for a long time. The first reported cases were in monkeys at a research institute in Denmark – hence the name. It’s a bad name for the disease, though. Like us, monkeys aren’t the natural host of the virus responsible.
The monkeypox virus is very closely related to the Variola virus that used to cause smallpox. Variola was declared eradicated in 1980, thanks to a very successful global vaccination campaign.
The even better news is that there is already a monkeypox vaccine approved for use in people.
The bad news is that the vaccine is made by only one company in the world, Denmark’s Bavarian Nordic. The company started in 1994 and, as well as having its monkeypox vaccine approved by the European Union in 2013, it has also worked on developing vaccines for the Ebola and Marburg viruses.
At the end of 2019, Bavarian Nordic bought two new vaccines from pharmaceutical giant Glaxosmithkline – one that protects people against rabies, and another that protects against European tickborne encephalitis.
Tick-borne encephalitis is a nasty disease. About a third of people have symptoms such
as headaches, difficulty concentrating, and memory problems for a year or more.
That’s where the news gets worse. Before the monkeypox outbreak started, Bavarian Nordic shut down its vaccine manufacturing plant so it could upgrade it to make its new rabies and tick-borne encephalitis vaccines too. It’s still shut and won’t be back online till the end of the year.
It also sounds like the United States has bought up most of the existing monkeypox vaccine doses. Everywhere else is running out, if they haven’t done so already.
Given the current outbreak, the World Health Organisation and other pharma companies have reached out to Bavarian Nordic with offers to manufacture the vaccine, but astonishingly it sounds like those offers haven’t been taken up.
Now we have yet another example of how broken the current system is for developing, manufacturing, and distributing medicines and vaccines. It’s an absolute disgrace.
The same thing happened with the Covid19 vaccines. Despite knowing the entire world would need doses, demand quickly outstripped supply. Market forces took over and stark and predictable inequities emerged in who got access to this precious new resource. Efforts by South Africa and India to get the patents waived were thwarted.
It’s nearly two years since the Covid-19 vaccines started being given to people outside clinical trials and those inequities still exist. People are dying every day because of them.
Monkeypox isn’t a new problem. The Democratic Republic of Congo has been battling it for decades, despite the existence of a vaccine. How many more people will have to suffer from this awful disease because the world is unwilling to put people before profits?
Dr Siouxsie Wiles MNZM is an awardwinning microbiologist and science communicator based in Auckland.