United Nations — Yesterday, India's Federal Health Ministry reported the nation's first documented case of mpox. The infected individual was reported to have contracted the clade Ib strain of the virus, which is a far deadlier variant than the more common clade II. This development has raised considerable concern among health officials around the world as the mpox epidemic had been contained in the Democratic Republic of Congo until recently.
In August, the World Health Organization (WHO) declared the emerging mpox epidemic to be a "global health emergency". In the early stages of the epidemic, around 90 percent of all cases had been reported in the Democratic Republic of Congo. In the following weeks, infections were reported in neighbouring states, including Kenya, Burundi, and Rwanda. The virus had also spread to non-African countries, such as Pakistan, Thailand, and Sweden.
The Africa Centres for Disease Control and Prevention (ACDC) reported a 160 percent rise in cases from the previous year, adding that most of these cases are from the deadlier clade I variant. Additionally, in the past few weeks, there have been a considerable uptick in cases in Kinshasa, the capital city of Congo. According to the Democratic Republic of Congo's Ministry of Health, Kinshasa had only seen 525 cases of transmission as of September 15. However, 10 percent of those cases had been reported in the final week of that testing period, indicating to analysts that rates of transmission are on the rise.
Although there have been few cases of the clade Ib strain detected, as well as zero fatalities, outside of Congo, health officials around the world have set up processes to track the spread and isolate infected individuals. The European Centre for Disease Prevention and Control (ECDC) urged for continued vigilance surrounding this epidemic, stating, "The size of these outbreaks could be larger than reported due to under-ascertainment and under-reporting". It is estimated by the Congolese Health Ministry that only 20 percent of mpox cases are confirmed, with most never seeking care or having their symptoms brushed off as chickenpox.
Congolese health officials have long advocated for a strong mpox vaccination campaign to be conducted, believing that it is paramount to eradicating this health crisis. "The expanding outbreak and the ongoing difficulties controlling it using traditional public health measures highlight the clear role of vaccines as part of the comprehensive response. A strong, well-coordinated mpox vaccine rollout, built on the lessons learned from the COVID-19 and Ebola vaccine rollouts, among others, is essential", stated WHO Regional Office of Africa.
On September 13th, WHO approved its first prequalification for a vaccine against mpox.
Dr Yukiko Nakatani, WHO Assistant Director-General for Access to Medicines and Health Products, states, "The WHO prequalification of the MVA-BN vaccine will help accelerate ongoing procurement of the mpox vaccines by governments and international agencies such as Gavi and Unicef to help communities on the frontlines of the ongoing emergency in Africa and beyond".
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The MVA-BN vaccine is currently only licensed for people who are over 18 years of age and not pregnant or immunocompromised. Patients are given two doses of injections, delivered four weeks apart.
The WHO Strategic Advisory Group of Experts (SAGE) on Immunization states that off-label use of the MVA-BN vaccine for all patients may be permitted as the benefits of widespread vaccination far outweigh potential risks. Studies show that one dose of the vaccine prior to infection boasts 76 percent immunization, while 2 doses yield 86 percent immunization. WHO is currently in the process of facilitating widespread vaccine rollouts and urges donor contributions so initiatives can be scaled up.
IPS UN Bureau Report
