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African leaders should have done much more to prepare for the mpox outbreak

Lenias Hwenda
By Lenias Hwenda
28 Aug 2024
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Africans would be justified in wondering why the Africa CDC began negotiating access to mpox vaccines only last week following months of a gradually worsening outbreak.

Two weeks ago, the World Health Organization (WHO) declared another public health emergency of international concern, this time as a result of the mpox outbreak in Africa.

It is notable that during the mpox public health emergency of international concern declared by the WHO in 2022 as a result of outbreaks in Europe and the US, the European Commission contracted Bavarian Nordic to supply more than two million doses of mpox vaccines. The EU Commission distributed these vaccines to EU countries.

Neither the African Union (AU) nor its public health agency, the African Centre for Disease Control and Prevention (Africa CDC), has made a similar vaccine purchase to protect Africans in affected countries.

The Africa CDC only announced that it was negotiating with the vaccine manufacturer last week. This was after months of an escalating mpox outbreak in the region, and after the agency itself declared a continental emergency security concern.

The manufacturer of the only available vaccine, Bavarian Nordic initially indicated a willingness to work directly with the Africa CDC to make vaccines available.

However, shortly afterwards the company said it was not going to take direct orders from African countries and that vaccines to African countries would be made available through donors.

Ethical questions


Ruling out selling vaccines directly to African countries raises ethical questions. It is also an unfair position to take towards affected communities.

While this is a disagreeable situation for African countries, it is not enough to simply ask business enterprises to do more to ensure that their products for infection prevention and control are available to populations in need in a timely manner. We must also ask whether African leaders did enough and are doing enough to secure those products and protect the health and economic security of the continent.

According to Bavarian Nordic, not a single African nation has made a request to buy vaccines.

Africans are therefore justified in wondering why the Africa CDC began negotiating access to the vaccine only last week following months of a gradually worsening outbreak. No vaccines are available at all, not even for the protection of frontline health professionals who are critical to bringing the mpox outbreak under control.

An obvious explanation is that vaccines are unavailable because African leaders took no action to acquire them, which boggles the mind.

Unlike the Covid-19 pandemic which caught the world unprepared, the current mpox outbreak had a lead time of months during which the Africa CDC and the African Union could have taken action to ensure adequate preparedness, including by pre-purchasing vaccines. This clearly did not happen.

At a minimum, Africans need to know that their leaders did all they could to access vaccines, but did not succeed. The unfortunate appearance, however, is that African leaders made no effort to do the most obvious thing under the circumstances – request vaccines for purchase from the manufacturer ahead of time.
It has been a habit for many of our (African) leaders to ignore the fundamental need and chase shadows

A former regulatory expert from the Nigerian regulatory agency Nafdac, Hashim Ubale Yusufu, said: “It has been a habit for many of our (African) leaders to ignore the fundamental need and chase shadows. It will be later when they realise their mistakes and go helter-skelter finding the solutions.”

In this particular case, could African leaders have done more to protect African populations by doing what the EU Commission did for its member countries during the 2022 mpox outbreak in their region?

Africans deserve to know whether enough was done to protect them. If not, then were there extenuating circumstances that prevented the Africa CDC from preparing adequately? If so, what were those circumstances and what can be done to mitigate them in the next outbreak?

After the EU Commission contracted Bavarian Nordic to supply more than two million doses of mpox vaccines to protect Europeans, European governments still have significant stockpiles of those vaccines available.

Now Africans must depend on the EU Commission asking its governments to pledge vaccines to the African response through the Team Europe initiative.

The EU Commission cannot, however, compel governments in Europe to donate vaccines. It is unlikely that any country will donate a significant quantity of the vaccine that they may need to protect their own populations. We know this because we have been here before. 

Of the 10 million doses that Africa needs, the best it can expect are dribs and drabs of vaccines from disparate sources like the expected US donation of 10,000 doses.

Africans might have expected their leaders to have learned the lessons of the Covid-19 pandemic and hoped for better this time. DM

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