Dr. Javier Guzman, director of global health policy at the Center for Global Development, said most wealthy countries have stockpiled enough smallpox vaccine to distribute it from their stockpiles while protecting national security.
“For example, Japan has stockpiled around 200 million doses of the LC16 vaccine. Simply donating 3 million doses, as Japan has done, will reduce the stockpile slightly. Similarly, Spain has committed to donating 500,000 doses, which is around 20% of its MPOX vaccine stockpile,” he said.
“If more high-income countries were to take similar steps, the chances of containment would be significantly increased and African countries would have less need to wait for new vaccines to be produced.”
Dr Guzman also reiterated that it would be a “mistake” to ignore the current threat from more deadly strains that are already widely circulating.
“When high-income countries conduct their risk-benefit analysis, they should take into account that, according to WHO, despite concerns about the possibility of deliberate release, the risk of smallpox in high-income countries is very low. In contrast, the risk of further spread of smallpox is a real and imminent threat.”
However, limited donations are not the only reason why the MPOX vaccine has been slow to become available.
“The world is currently facing huge challenges around access to medical countermeasures,” said Professor Rebecca Katz, director of the Center for Global Health Science and Security at Georgetown University Medical Center.
“This happens for a lot of reasons. It has everything to do with national security implications, to production costs, to legal and regulatory barriers, to getting products to the right people. And there are no easy solutions to any of this.”
The outbreak has highlighted regulatory issues: It was only on September 13 that the WHO approved the first doses of the Bavarian Nordic MPOX vaccine, through a process called prequalification.
This is important for two reasons. First, many low- and middle-income countries that don’t have strong regulatory bodies also rely on the WHO to determine which medical tools are safe and effective, except in the case of the Democratic Republic of Congo, which approved two mpox vaccines in late June.
Second, and perhaps more importantly, UN agencies and Gavi need WHO approval to buy and distribute any vaccine, which is why Gavi announced last Wednesday that it would be purchasing its first doses of the Bavarian Nordic mpox vaccine for use in this outbreak.
