Gavi mobilizes global response to Mpox outbreak in Africa

SWITZERLAND—Gavi, the Vaccine Alliance, a public-private collaboration responsible for immunising more than half of the world’s children against life-threatening diseases, has expressed concern over the rising Mpox outbreak in Africa.

This concern comes after the African Centres for Disease Control and Prevention (Africa CDC) and the World Health Organisation (WHO) declared Mpox a Public Health Emergency of Continental Security and a Public Health Emergency of International Concern, respectively.

In a statement, Gavi pointed out the importance of these statements, emphasising how they set the basis for a comprehensive, region-led response to the Mpox outbreak.

The agency also emphasised the need of international collaboration in combatting the disease’s spread, emphasising the need for a coordinated worldwide effort to confront the ongoing disaster.

Since 2022, Gavi has actively worked with nations and partners to closely monitor the Mpox situation.

The organisation’s ongoing outbreak evaluations have inspired the creation of new health security methods aimed at addressing systemic flaws discovered during the COVID-19 vaccination distribution.

In addition, Mpox concerns have been integrated into Gavi’s five-year strategy planning, with pox vaccines being considered in the early stages of Gavi’s review for its next Vaccine Investment Strategy (VIS) in 2023.

To ensure a comprehensive approach, the VIS Steering Committee held special sessions in the first quarter of 2024, focusing on developments in the Democratic Republic of the Congo (DRC), where the Mpox outbreak has rapidly spread, primarily affecting children and resulting in a high case fatality ratio.

As a result, in June 2024, the Gavi Board adopted procedures to construct a worldwide stockpile of Mpox vaccines in its second strategic phase, which begins in 2026. The stockpile will be modelled after current ones for diseases such as cholera, Ebola, meningitis, and yellow fever.

However, the creation of the stockpile is contingent on the WHO Emergency Use Listing or prequalification of a recommended vaccine and successful fundraising efforts for Gavi’s upcoming strategic period.

A key objective of this initiative will be to ensure that the design of the stockpile is informed by a thorough assessment of long-term public health needs.

In the meantime, Gavi will continue to support outbreak response efforts in the DRC and surrounding countries.

Gavi has committed to making critical investments in a learning agenda that will help refine and improve future vaccination efforts, including designing the global Mpox vaccine stockpile.

Gavi has also been monitoring the Mpox situation daily to boost ongoing emergency response efforts and is working closely with countries, Africa CDC, WHO, UNICEF, donors, and vaccine manufacturers.

As part of its immediate response, Gavi has officially declared the Mpox situation a regional emergency, which enables the organization to implement additional flexibilities and streamline processes.

This includes potentially repurposing available funds to support vaccine response efforts, such as operational costs for using donated doses, and waiving the formal independent review process for new vaccine introductions and campaigns.

In addition, Gavi is leveraging innovative mechanisms to enhance its response to the Mpox crisis, whereby in June 2024, the Gavi Board approved the final terms of the First Response Fund, the quickest tool in a suite of instruments known as the Day Zero Financing Facility.

This fund, developed as a critical lesson from the COVID-19 pandemic, ensures that resources are immediately available for a vaccine response during urgent public health emergencies.

Gavi is also accelerating its engagement with vaccine manufacturers, including Bavarian Nordic, to procure Mpox vaccines directly.

The WHO recently announced that two vaccines are under consideration for Emergency Use Listing. This crucial interim measure allows partners to act swiftly, even before the expected longer timeframe for WHO prequalification.

Furthermore, Gavi has initiated dose donations and emergency response efforts, building on its experience of coordinating nearly one billion dose donations to 114 countries during the COVID-19 pandemic.

This initiative will enable Gavi to provide direct support and share knowledge with countries and partners, while assisting in the design of in-country vaccination strategies.

In collaboration with the Government of DRC, Africa CDC, WHO, UNICEF, and other partners, Gavi recently participated in a workshop to develop a three-phase vaccine response strategy based on the available supply of donated doses.

Additionally, Gavi is offering legal and process expertise, along with operational support, to Africa CDC and other partners involved in sourcing dose donations.

As part of its comprehensive approach, Gavi is also working to enhance data collection on disease burden and epidemiology, supporting surveillance and modelling studies on vaccine use and impact.

Gavi hopes that by expanding available data, the future global stockpile will address long-term public health requirements and strengthen Mpox immunization efforts.

In the coming weeks, Gavi will continue collaborating with partners to finalise the design of this agenda and issue a Request for Proposals, further solidifying its commitment to combating the Mpox outbreak and safeguarding