Global Health: Lessons from COVID-19 Bolster Response to Mpox Outbreak in Africa, Says Gavi

The world is better equipped to handle the ongoing mpox epidemic in Africa, thanks to critical lessons learned from the COVID-19 pandemic, according to the Gavi vaccine alliance. Gavi’s chief, Sania Nishtar, highlighted how the global health community has adapted, using the lessons from the pandemic to develop stronger mechanisms for responding to health emergencies.

“The COVID catastrophe brought important learnings, and those learnings were drawn upon,” Nishtar said in a recent interview. She emphasized that these lessons have led to specific tools now being deployed to combat mpox, previously known as monkeypox. Nishtar, a former Pakistani health minister, became Gavi’s first female leader earlier this year.

Pandemic Exposed Unpreparedness and Inequities

When COVID-19 first emerged in early 2020, the rapid global spread of the virus exposed significant gaps in the world’s preparedness for a health crisis of this magnitude. One of the most glaring issues was global vaccine inequity, as wealthier nations quickly bought up vaccine supplies, leaving developing countries, particularly in Africa, lagging behind.

While countries continue to negotiate a new pandemic treaty to improve future global preparedness, organizations like Gavi have taken proactive steps to enhance emergency response capacity. Nishtar pointed out that Gavi has already initiated measures to ensure swifter vaccine access for poorer countries, without waiting for international agreements.

One such initiative is Gavi’s $500 million First Response Fund, launched in June. The fund aims to provide rapid financial support for vaccines during health emergencies, addressing one of the major shortcomings seen during the COVID-19 crisis.

“The learnings from COVID were that when an emergency hits, there often isn’t money available,” Nishtar explained. The First Response Fund is designed to prevent such delays in the future.

Gavi’s Rapid Response to Mpox

Gavi announced its first use of the First Response Fund earlier this week. The organization has secured 500,000 doses of the MVA-BN mpox vaccine from Danish pharmaceutical firm Bavarian Nordic for distribution in African countries currently grappling with the epidemic.

“We’re drawing up to $50 million from the First Response Fund,” said Nishtar, adding that the funds will cover both the cost of the vaccine doses and related overheads like logistics and delivery.

Gavi’s quick action is crucial, as mpox continues to surge in Africa, particularly in the Democratic Republic of Congo (DRC), where the new Clade 1b strain of the virus has triggered widespread concern. Between January and August 2023, DRC reported nearly 22,000 mpox cases and over 700 deaths.

The World Health Organization (WHO) declared an international emergency over the virus last month, underscoring the urgency of the situation.

Mpox, which is transmitted from animals to humans and through close physical contact, causes fever, muscle aches, and painful skin lesions. While it can be deadly, vaccines like the MVA-BN are proving effective in controlling outbreaks.

Accelerating Vaccine Production and Distribution

The swift action by Gavi and its partners contrasts sharply with the slower response during COVID-19. Nishtar highlighted that just 35 days passed between WHO’s emergency declaration on mpox and Gavi’s advance purchase agreement for the vaccines, which she described as “as fast as you can get.”

Gavi is also taking longer-term measures to build up global preparedness. In June, the organization announced plans to establish a global stockpile of mpox vaccines by 2026, following similar efforts for vaccines against cholera, Ebola, meningitis, and yellow fever. This stockpile will help ensure vaccines are readily available for future outbreaks.

In addition to vaccine stockpiling, Gavi has launched a vaccine production “accelerator” for Africa. The accelerator aims to channel up to $1.2 billion over the next decade to expand vaccine manufacturing on the continent. This is seen as a critical step in ensuring Africa’s self-reliance in vaccine production, addressing one of the key issues exposed during COVID-19.

Challenges Ahead

Despite progress, the mpox outbreak in Africa still poses significant challenges. The Africa Centres for Disease Control and Prevention has called for 10 million vaccine doses to be secured for the continent, but so far, only 3.6 million have been obtained.

Last week, WHO pre-qualified the MVA-BN mpox vaccine, marking the first time a vaccine for mpox has received this important endorsement. The pre-qualification process will help streamline the procurement process, enabling international organizations like Gavi to distribute doses more efficiently.

Nishtar is optimistic about the global community’s response to mpox compared to the disjointed efforts seen at the start of the COVID-19 pandemic. “All in all, we’re in a much better scenario than we were with COVID,” she said, emphasizing that the world has learned valuable lessons and put stronger systems in place to avoid repeating past mistakes.

A Better Future for Global Health

While challenges remain, Gavi’s rapid response to the mpox outbreak demonstrates the importance of preparedness and coordination in global health. By applying lessons learned from COVID-19, Gavi and other health organizations are better positioned to tackle current and future epidemics.

As the world continues to navigate new health crises, Gavi’s efforts to ensure vaccine equity, improve emergency funding, and strengthen vaccine production in Africa represent critical steps toward a more resilient global health system.