Miami Herald (Sunday)

In race for monkeypox vaccines, experts see repeat of COVID

- BY MARIA CHENG Associated Press

LONDON

Moves by rich countries to buy large quantities of monkeypox vaccine, while declining to share doses with Africa, could leave millions of people unprotecte­d against a more dangerous version of the disease and risk continued spillovers of the virus into humans, public health officials are warning.

Critics fear a repeat of the catastroph­ic inequity problems seen during the coronaviru­s pandemic.

“The mistakes we saw during the COVID-19 pandemic are already being repeated,” said Dr. Boghuma Kabisen Titanji, an assistant professor of medicine at Emory University.

While rich countries have ordered millions of vaccines to stop monkeypox within their borders, none have announced plans to share doses with Africa, where a more lethal form of monkeypox is spreading than in the West.

To date, there have been more than 22,000 monkeypox cases reported in nearly 80 countries since May, with about 75 suspected deaths in Africa, mostly in Nigeria and Congo. On Friday, Brazil and Spain reported deaths linked to monkeypox, the first reported outside Africa. Spain reported a second monkeypox death Saturday.

“The African countries dealing with monkeypox outbreaks for decades have been relegated to a footnote in conversati­ons about the global response,” Titanji said.

Scientists say that, unlike campaigns to stop COVID-19,

mass vaccinatio­ns against monkeypox won’t be necessary.

They think targeted use of the available doses, along with other measures, could shut down the expanding epidemics that were recently designated by the World Health Organizati­on as a global health emergency.

Yet while monkeypox is much harder to spread than COVID-19, experts warn if the disease spills over into general population­s — currently in Europe and North America it is circulatin­g almost exclusivel­y among gay and bisexual men — the need for vaccines could intensify, especially if the virus becomes entrenched in new regions.

On Thursday, the Africa Centers for Disease Control and Prevention called for the continent to be prioritize­d for vaccines, saying it was again being left behind.

“If we’re not safe, the rest of the world is not safe,” said Africa CDC’s acting director, Ahmed Ogwell.

Although monkeypox has been endemic in parts of Africa for decades, it mostly jumps into people from infected wild animals and has not typically spread very far beyond the continent.

Experts suspect the monkeypox outbreaks in North America and Europe may have originated in Africa long before the disease started spreading via sex at two raves in Spain and Belgium. Currently, more than 70% of the world’s monkeypox cases are in Europe, and 98% are in men who have sex with men.

Catherine Smallwood, a senior emergencie­s officer at WHO Europe, said the deaths in Spain did not change the agency’s assessment of the outbreak.

“Although the disease is self-limiting in most cases, monkeypox can cause severe complicati­ons,” she said in an email, adding that about 8% of infections reported had required hospitaliz­ation and that monkeypox could sometimes lead to life-threatenin­g complicati­ons like encephalit­is.

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