GS Paper - III

The Democratic Republic of Congo (DRC) — epicentre of the mpox outbreak that has become virulent and spread to other countries — has received its first donation of mpox vaccines. Since 1 January 2022, mpox cases have been reported from 121 countries, including 20 WHO member-states across Africa. On 9 September 2024, India confirmed its first mpox case, which was a travel-related infection.

Why is the spread of mpox a concern?

• Mpox, which was first reported in humans in 1970, has come under the spotlight largely due to the spread of its new clade Ib variant.
• Organisms belonging to a clade share common ancestors. When it comes to mpox, there are two different clades: clade I and clade II; the former is the deadlier of the two.
• Clade Ib seems to be transmitting more rapidly between people than previous variants, including through sexual activity.
• Clade Ia mostly comes from animals, according to a report in the journal Nature. The new variant is also affecting more women and children in the impacted African countries.
• Scientists are still trying to determine the reasons behind these aspects of the transmission.

What vaccines are being used against mpox?

• Three mpox vaccines are available currently. All are weakened versions of vaccinia, a live virus that also served as the basis for the smallpox vaccine.
• The most commonly used vaccine is modified vaccinia Ankara (MVA), manufactured by Denmark-based Bavarian Nordic.
• It has approval for mpox from both the US Food and Drug Administration (FDA) and European Medicines Agency (EMA). The DRC has received this vaccine.
• The other vaccine is LC16m8, which is produced by KM Biologics, a company in Japan. Only Japan’s regulatory authority has approved this vaccine for mpox.
• The third is ACAM2000, which is made by a US company, Emergent BioSolutions. It was approved for mpox by the FDA last month.
• New mpox vaccines are also being developed. A vaccine by BioNTech, a German biotechnology company, is currently in early clinical development.

Why did Africa not get mpox vaccines sooner?

• The currently available mpox vaccines are too expensive — $50 to $75 per dose, according to the WHO — for African countries.
• As a result, they have to usually rely on direct donations by developed countries and vaccine producers and on purchases by Global Alliance for Vaccines and Immunization (Gavi, the Vaccine Alliance) and UNICEF.
• Gavi and UNICEF cannot buy vaccines unless the WHO issues an Emergency Use Listing to products or gives them full approval, according to a report in the journal Science. To get these, companies have to submit efficacy and safety data about their products.
• Some experts have said the WHO has been too slow in giving such approvals. However, WHO Director-General Tedros Adhanom Ghebreyesus said last month that the delay was due to the companies’ failure to complete the required paperwork.

When should the mpox vaccine be taken?

• Getting a vaccine is recommended for a high-risk population, especially during an outbreak.
• The vaccine can also be administered after a person has been in contact with someone who has mpox.
• In these cases, the vaccine should be given less than four days after contact with an infected person.
• The vaccine can be administered for up to 14 days if the person has not developed symptoms.