Mpox vaccine rollout in Africa delayed as UNICEF struggles with supply agreements

The rollout of mpox vaccines in Africa could face significant delays, as the United Nations Children’s Fund (UNICEF) remains in the early stages of securing doses through an emergency tender. This effort is being coordinated with the GAVI vaccine alliance, the Africa Centres for Disease Control and Prevention (Africa CDC), and the World Health Organisation (WHO), as stated in a joint announcement made on Saturday, August 31.

Agreements to secure up to 12 million doses of the mpox vaccine through 2025 depend on manufacturers’ ability to ramp up production. As such, the actual distribution of these vaccines may take several months, leaving countries in crisis waiting for the needed supplies. “The UNICEF tender is issued to help secure mpox vaccines for the hardest-hit countries in collaboration with Africa CDC, Gavi, the Vaccine Alliance, WHO, the Pan American Health Organization, and other partners,” an official UNICEF readout stated. This collaborative effort also aims to facilitate donations from existing stockpiles in high-income countries to curb the ongoing spread of mpox.

Africa’s struggle with the mpox vaccine rollout

The path to vaccine availability involves UNICEF establishing “conditional supply agreements” with vaccine manufacturers, similar to those put in place during the Covid-19 pandemic. This approach allows UNICEF to purchase and distribute vaccines quickly once countries and partners secure financing, confirm demand and readiness, and ensure all regulatory requirements are fulfilled.

The World Health Organisation is currently reviewing submissions from vaccine manufacturers, submitted on August 23, and expects to conclude its assessment for Emergency Use Listing by mid-September. These reviews are crucial for expediting the availability of vaccines in affected regions.

As the crisis continues, the Democratic Republic of the Congo (DRC) remains at the epicentre, reporting more than 18,000 suspected cases of mpox, including 629 deaths in 2024 alone. Alarmingly, four out of five fatalities have been in children, highlighting the urgent need for vaccines.

Urgent need for equitable vaccine distribution

Leila Pakkala, Director of UNICEF’s Supply Division, emphasized the importance of addressing the current mpox vaccine shortage and delivering vaccines to communities that urgently need them. “There is also a pressing need for a universal and transparent allocation mechanism to ensure equitable access to mpox vaccines,” Pakkala said, underlining the necessity for global cooperation in vaccine allocation and distribution.

The international community, particularly high-income countries with existing vaccine stockpiles, plays a crucial role in addressing the current shortage by facilitating donations to countries in need. However, the success of these efforts will hinge on the ability to swiftly conclude agreements, secure production capacities, and navigate regulatory requirements efficiently.

Moving forward: The path to vaccination

While the timeline for mpox vaccine availability in Africa remains uncertain, the collaboration among UNICEF, Africa CDC, WHO, GAVI, and other partners represents a significant step towards combating the spread of the virus. The ongoing efforts to increase vaccine production and secure donations will be critical in ensuring that the vaccine reaches those who need it most.

As Africa faces one of its most challenging public health crises in recent times, the speed and effectiveness of vaccine rollout will likely determine the extent to which the continent can control and eventually eliminate mpox transmission.