Stigma, regulatory barriers delay mpox response in country that needs it
most
Send a link to a friend
[December 05, 2023]
By Jennifer Rigby
LONDON (Reuters) - Vaccines and treatments that could help tackle an
mpox epidemic in the Democratic Republic of Congo are lying unused
outside the country despite a death rate far higher than from the global
outbreak that began last year.
Stigma, regulatory hurdles and competing disease outbreaks are all
factors holding back the response, according to almost a dozen
scientists, public health officials and drugmakers involved.
Since January, at least 581 people have died of mpox in Congo out of
12,569 suspected cases, compared to 167 deaths among 91,788 reported
cases in 116 other countries since January 2022, according to the World
Health Organization.
Mpox is a viral infection that spreads through close contact and causes
flu-like symptoms and pus-filled skin lesions.
The WHO sent a team to the country last month to help the authorities
there, but there are still no treatments or vaccines available for use
in Congo outside of clinical trials. A team working for Médecins Sans
Frontières (Doctors without Borders) in one district confirmed the lack
of specific tools to fight the disease.
That is in part because the government in Congo, one of the world's
poorest countries, has not asked to buy any or applied for donations,
according to representatives from the drugmakers as well as from
high-income countries with stockpiles.
![](http://archives.lincolndailynews.com/2023/Dec/05/images/ads/current/rohlfs_lda_WORSHIP_2023.png)
Congo is fighting a number of other outbreaks, including measles and
cholera, and around a quarter of its population requires humanitarian
assistance. Conflict has also intensified in eastern Congo in recent
years.
Mpox was re-named from monkeypox last year to avoid stigma, but
increasing evidence that the disease can spread through sexual contact,
particularly among men who have sex with men, has renewed fears of
discrimination.
In addition, medical mpox countermeasures have not been cleared for use
by Congo regulators, the countries with stockpiles and drugmakers said,
another obstacle to selling or donating doses. The Congolese government
did not respond to requests for comment.
An attempt to donate doses of mpox vaccine has been stalled for more
than a year for this reason, Bavarian Nordic Chief Executive Paul
Chaplin said in a statement.
The company, which makes the vaccine Jynneos, is supporting donation by
an organization that bought doses, and has submitted a dossier for a
domestic emergency use authorization in Congo, the CEO said.
Global health officials said a lack of urgency was a sign the world had
learned nothing from the unequal access to vaccines during the COVID-19
pandemic.
![](http://archives.lincolndailynews.com/2023/Dec/05/images/ads/current/peasley_sda_HFH_2023.png)
[to top of second column]
|
![](../images/120523PIX/health23.jpg)
Alingo Likaka Manasse, head nurse at the Yalanga Health Centre,
examines lesions on the hands of Lituka Wenda Dety, 41, who is
suffering from monkeypox, in Yakusu, Tshopo, Democratic Republic of
the Congo, October 2, 2022. REUTERS/Arlette Bashizi/File Photo
![](http://archives.lincolndailynews.com/2023/Dec/05/images/ads/current/atlantabank_quarter_FFARM_2023.png) “This is a stain on our humanity,”
said Winnie Byanyima, the head of the United Nations AIDS programme,
who has been vocal on inequality and stigma during pandemics. “What
are we waiting for?”
Both the mpox vaccine and treatment were originally developed to
tackle a re-emergence of smallpox, a related deadly disease
eradicated decades ago. Wealthy nations keep small stockpiles in
case the disease returns, and repurposed some when mpox began to
spread to countries where it was not endemic.
The WHO also has access to a small stockpile of both, and requires
applications from countries that need them. The organization did not
respond to requests for comment.
'HOSTILE' ENVIRONMENT
Recent evidence has shown for the first time that the type of mpox
spreading in Congo, known as clade I, can be transmitted through
sexual contact. This proved to be the main transmission mode for the
less deadly strain of the disease that broke out globally last year,
chiefly among gay, bisexual and other men who have sex with men.
It was previously thought that both types of mpox spread mainly
through close contact among humans after spilling over from an
infected animal through bites, scratches, hunting, or cooking.
African scientists said they were concerned the sexual stigma could
hamper spread prevention. While homosexuality is not illegal in
Congo, it is not widely accepted.
“This is taking place in an environment hostile to homosexual
activities,” said Oyewale Tomori, a leading Nigerian virologist with
mpox expertise. “This is likely to hamper field investigations...
and formulation of appropriate response and control measures.”
![](http://archives.lincolndailynews.com/2023/Dec/05/images/ads/current/ldn_sda_NILA_012823.png)
SIGA Technologies, which makes the antiviral drug TPOXX (tecovirimat),
said this could make a treatment easier to deploy. A vaccine would
require people to come forward potentially admitting they belong to
the high risk group.
Unlike the vaccine, the treatment has not yet been approved by the
U.S. Food and Drug Administration. Its use worldwide is under
emergency protocols applied by each country. While no gold-standard
clinical trial has yet proved its safety and effectiveness,
real-world data supports this, SIGA said.
“If the clinical trial shows what we expect it to show," said Jay
Varma, chief medical officer at SIGA, "there will hopefully then be
more political interest in trying to come up with a long-term
procurement and delivery strategy.”
(Reporting by Jennifer Rigby, editing by Michele Gershberg and Bill
Berkrot)
[© 2023 Thomson Reuters. All rights
reserved.]This material may not be published,
broadcast, rewritten or redistributed.
Thompson Reuters is solely responsible for this content. |