Emerging Global Health Crisis: Mpox Outbreak

Less than five years after the COVID-19 pandemic, the world faces another global health crisis. The World Health Organization (WHO) has declared mpox (formerly known as monkeypox) a Public Health Emergency of International Concern (PHEIC), following an outbreak in the Democratic Republic of the Congo (DRC) and its subsequent spread to over a dozen African countries. This outbreak has also prompted the Africa Centres for Disease Control and Prevention (Africa CDC) to declare a Public Health Emergency of Continental Security (PHECS), marking the first instance where both regional and global health emergencies have been declared for the same disease.

Global Spread of Mpox

Following the PHEIC declaration, mpox cases were identified in Sweden, Pakistan, and the Philippines, indicating the virus''s potential spread beyond the African continent.

Significance of WHO’s PHEIC Declaration

The WHO''s declaration is significant as it is the first PHEIC since the May 2024 amendments to the International Health Regulations (IHR). A key amendment includes equity as a core principle, emphasizing the need for a global response grounded in fairness and equal access to resources. Although these amendments will not take effect until 2025, the global response to mpox must adhere to these principles from the outset. The PHEIC declaration is intended to foster international cooperation, prompting countries, international organizations, and NGOs to collaborate, share information, and provide mutual assistance. This should lead to the rapid mobilization of financial and technical resources, including emergency funding, deployment of trained healthcare workers, and provision of medical supplies.

Lessons from the COVID-19 Pandemic

The COVID-19 pandemic highlighted the inadequacy of vaccine manufacturing capabilities in the Global South, worsened by the lack of technology transfers. The response to the mpox outbreak appears to be following a similar trajectory, but with one significant difference: the availability of a vaccine. The Modified Vaccinia Ankara-Bavarian Nordic (MVA-BN), also known as Jynneos, is already in production by Danish manufacturer Bavarian Nordic. Regulatory authorities in several countries have approved this vaccine, which presents an opportunity to apply lessons from COVID-19 by increasing vaccine production in the Global South and ensuring equitable access.

India’s Role in Vaccine Production

India, with its significant vaccine manufacturing capabilities, is well-positioned to play a critical role in ensuring equitable access to the MVA-BN vaccine. Indian manufacturers, particularly the Serum Institute of India, Bharat Biotech, and Zydus Cadila, have experience in producing vaccines using primary chick embryo fibroblast (CEF) cells, which are used in MVA-BN production. These manufacturers could scale up production quickly, leveraging existing supply chains and reducing vaccine costs, making doses more accessible.

The Importance of Technology Transfers

To meet the growing demand for the mpox vaccine, comprehensive technology transfers are crucial. This includes sharing biological resources, know-how, and patents. The article emphasizes that the transfer of knowledge, rather than just vaccine doses, is essential for achieving global justice rather than mere charity. India should collaborate with international organizations and negotiate with Bavarian Nordic for the transfer of technology, ensuring that low-cost vaccine production can be scaled up, curbing the epidemic and preventing further outbreaks.

India’s Regulatory Response

In a significant move on August 7, India’s drug regulatory agency, the Central Drugs Standard Control Organization (CDSCO), waived the requirement for clinical trials in India for drugs approved in several other countries. This waiver, which includes new drugs used in pandemic situations, will expedite the availability of critical vaccines like MVA-BN in India.

Conclusion: The Need for Immediate Action

The global community has a critical opportunity to demonstrate its commitment to equitable healthcare by ensuring widespread access to the mpox vaccine. By fostering international cooperation, prioritizing technology transfers, and leveraging the manufacturing capabilities of countries like India, the world can address the current crisis and strengthen preparedness for future public health emergencies. The time to act is now to prevent history from repeating itself.