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Watchdog Warns Mpox Vaccine Maker 'May Be Exploiting the Latest Global Health Crisis'
"We must question why Bavarian Nordic refuses to adjust its unconscionable approach to pricing and access," wrote the director of Public Citizen's Access to Medicines program.
Aug 24, 2024
A U.S.-based watchdog group on Friday called out what it described as the "profiteering approach" taken by one of the only companies in the world with an approved vaccine for mpox, an infectious disease whose rapid spread in the Democratic Republic of Congo prompted the World Health Organization to declare a global emergency earlier this month.
Peter Maybarduk, the director of Public Citizen's Access to Medicines program, wrote a letter to the Danish pharmaceutical giant Bavarian Nordic expressing deep concern that the company "may be exploiting the latest global health crisis, putting profits over people."
A spokesperson for Bavarian Nordic, the maker of the mpox vaccine Jynneos, toldSTAT in a recent interview that the firm doesn't "tend to talk about price," a lack of transparency that set off alarm bells amid a pressing international crisis. Mpox has spread to the DRC's neighboring countries, and Thailand and Sweden each recently reported a case.
Maybarduk elaborated on his concerns:
In 2022, the Pan American Health Organization (PAHO) resolved to procure mpox vaccines despite Bavarian Nordic’s refusal to provide a single low price for all PAHO Member States. Consequently, the vaccine costs much more than any of the other vaccines available through the Revolving Fund, PAHO's bulk vaccine purchaser. In negotiations with manufacturers, the Revolving Fund usually seeks to obtain a supplier's lowest available price to ensure that all PAHO Member States can access affordable vaccines, regardless of size or level of development.
Given Bavarian Nordic's troubling approach to pricing with PAHO then, we remain concerned about pricing implications now for group procurement by Africa CDC and multilateral purchasers such as Gavi, as well as wider ramifications for the global public health response.
"While many actors have roles to play in ensuring a coordinated international effort to contain the spread of mpox, including how best to make use of vaccines," Maybarduk added, "we must question why Bavarian Nordic refuses to adjust its unconscionable approach to pricing and access."
The WHO's emergency declaration and the lack of vaccine access in the countries most affected by mpox has sparked concerns of a repeat of the vaccine apartheid that undermined the global response to Covid-19, with deadly consequences.
Lawrence Gostin, Sam Halabi, and Alexandra Finch, experts at the O'Neill Institute for National and Global Health Law at Georgetown University, wrote in a New York Timesop-ed earlier this week that "we shouldn't discount the pandemic potential of mpox."
"Africa CDC has estimated that it needs 10 million doses to stop the current outbreak. But as was the case with the Covid vaccines, mpox vaccines are in the hands of the world's richest countries and companies," the experts wrote. "An agreement between Africa CDC, the European Union, and Bavarian Nordic has already been reached for the procurement and rapid distribution of about 200,000 doses, but many more are needed. The United States has said it will donate 50,000 doses to Congo from its stockpile. But this still leaves Africa nowhere near the 10 million doses needed."
"Bavarian Nordic says that by the end of this year it could manufacture two million more doses, and then eight million doses next year, if purchase orders are made," they added. "But there is no clear commitment to make these doses affordable for African countries."
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Global Health Advocates Call for Massive Mpox Vaccination Effort
"Every necessary step must be taken to get mpox vaccines to the adults and children who need them now," said an epidemiological coordinator for Doctors Without Borders.
Aug 16, 2024
The international medical charity Doctors Without Borders on Friday appealed to wealthy countries that have stockpiles of mpox vaccines to immediately donate doses to several countries in Africa that have been affected by recent outbreaks, as global officials warned the spread of the disease is now a public health emergency of international concern.
The group, also known by its French name, Médecins Sans Frontières (MSF), expressed support for the World Health Organization's (WHO) call for donor countries to help fund a coordinated response to the outbreak, including surveillance, building laboratory capacity, increasing community engagement, and guaranteeing access to treatments, vaccines, and testing.
The current outbreak has been reported mainly in the Democratic Republic of Congo (DRC), where the number of mpox cases this year has surpassed 15,600. More than 530 people have died of the disease this year.
Mpox has been reported in DRC for more than a decade, but with far fewer annual case numbers. More than 100 cases have also been confirmed in the past month in four neighboring countries which have not reported cases of the disease before: Burundi, Kenya, Rwanda, and Uganda.
Dr. Jean Kaseya, director-general of the Africa Centers for Disease Control and Prevention, estimated this week that at least 10 million doses of mpox vaccines will be needed to respond to the growing outbreak.
"We need to have vaccines," Kaseya told NPR. "Today, we are just talking about almost 200,000 doses [becoming] available. We need at least 10 million doses. The vaccine is so expensive—we can put it around $100 per dose. There are not so many countries in Africa that can afford the cost of this vaccine."
Without improved access to vaccines, said Justin Eyong, an intersectional epidemiological coordinator for MSF in DRC, "thousands of people—including children under 15 years old who are particularly affected by mpox (representing 56% and 79% of all cases and deaths from mpox in 2024, respectively)—may be left unprotected."
The U.S. Food and Drug Administration and European Medicines Agency have both approved the MVA-BN vaccine for mpox, which can cause a rash that can be painful and initially look like blisters, as well as fever, chills, and other symptoms.
"Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022. It is time to act decisively to prevent history from repeating itself."
With the current price of the MVA-BN vaccine placing it out of reach for most low- and middle-income countries where mpox is endemic or is now spreading, MSF called on its manufacturer, Bavarian Nordic, to partner with African companies "for a full and timely tech transfer" that would allow a vaccine to be produced in Africa.
"With the mpox outbreak in DRC continuing to evolve rapidly, the situation is urgent," Eyong said. "Every necessary step must be taken to get mpox vaccines to the adults and children who need them now."
The current outbreak of mpox is being driven by one of the two genetic clades, or groupings, that characterize the disease. Clade II was behind an outbreak that was declared a global health emergency from 2022-23, but the current spread of the virus is being driven by clade I, which causes more severe disease.
Dimie Ogoina, chair of the International Health Regulations Emergency Committee said Wednesday that the upsurge in cases is "an emergency, not only for Africa, but for the entire globe."
"Mpox, originating in Africa, was neglected there, and later caused a global outbreak in 2022," said Ogoina. "It is time to act decisively to prevent history from repeating itself."
Ogoina's comments were echoed by Ayoade Alakija, chair of the Africa Vaccine Delivery Alliance, who told The Guardian that if European countries were experiencing the current outbreak instead of African nations, "mpox would have already been considered a major international health emergency."
The declaration of an emergency "of international concern," said Alakija, "should focus minds and loosen purse strings so that the response recovers from a sluggish start."
Instead of confronting the threat of a potential new outbreak, said Global Justice Now director Nick Dearden, "the British government has spent more time actually stopping a pandemic treaty being agreed because it threatens Big Pharma power."
Policymakers in wealthy countries including the U.K. and the U.S. have objected to provisions in a pandemic treaty proposed by WHO, such as those that call for countries to donate vaccine doses to low-income countries or waive intellectual property laws for vaccines and treatments during a pandemic.
Such objections are "bad for all of us," said Dearden. "If we'd dealt with this internationally years ago, we could have prevented this dangerous new strain."
MSF called on WHO to accelerate its Emergency Use Listing (EUL) Procedure for two mpox vaccines that have been approved internationally, which would encourage manufacturers to increase production and allow agencies including the United Nations Children's Fund to distribute the vaccines.
The stockpiling of vaccines by "rich countries that do not need them," said economist Jayati Ghosh, "is exactly what the world does not need to confront this latest health threat."
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Armed Attacks on Schools and Hospitals in Conflict Zones Up 112% Last Year: UN
More than 8,800 children were killed or maimed in wars and other violence around the world in what a top U.N. official called another "dire" year for minors caught up in conflict.
Jun 27, 2023
There were more than 1,100 recorded armed attacks on schools and hospitals around the world last year—more than double the number reported in 2021—according to an annual report on children in wars and other conflicts published Tuesday by the office of United Nations Secretary-General António Guterres.
This year's Children and Armed Conflict Conflict report counts 8,831 children killed or injured in wars and other violence, with another 7,622 minors recruited by or forced to join armed groups.
The publication states there were 27,180 "grave violations" involving children in 24 different "conflict situations" last year, including 1,163 attacks on schools and hospitals—a 112% increase from 2021.
"The countries recording the highest number of violationswere the Democratic Republic of the Congo (DRC), Israel, the state of Palestine, Somalia, Syria, Ukraine, Afghanistan, and Yemen," according to the report.
The report said Myanmar, South Sudan, and Burkina Faso experienced the worst deterioration in regard to violations against children last year, while Haiti and Niger warrant growing concern.
The publication noted 3,377 U.N.-verified violations against or involving children in the DRC last year, nearly half of which involved recruitment by anti-government rebel groups.
"Many children growing up in the DRC are living through the toughest experiences imaginable," Greg Ramm, DRC country director for U.K.-based Save the Children, said in a statement.
"Every day children are experiencing harrowing violations against their rights. They've watched their homes and schools be destroyed," Ramm added. "Armed groups force their friends and family members into armed recruitment, and many have survived sexual and gender-based violence, abuse, and abductions."
Russia was added to the global "list of shame" this year due to its armed forces and allies killing or maiming 1,386 children during the ongoing invasion of Ukraine—which was left off the list even though its homeland-defending military killed or wounded 255 minors.
As Common Dreams reported last week, Israel—whose forces killed or injured nearly 1,000 children last year—and Palestine were also left off the "list of shame."
U.N. Special Representative for Children and Armed Conflict Virginia Gamba said there had been an "important decrease" in Israeli airstrikes during 2022, which critics said was only due to the fact that there was no full-scale Israeli war on Gaza last year like there was in 2021, when 67 minors were among the 256 Palestinians killed during Operation Guardian of the Walls.
However, Gamba voiced concerns over Israeli attacks in the illegally occupied West Bank and East Jerusalem, as well as violations committed by Palestinian militants resisting or retaliating against Israeli forces.
"Israel's continued omission from the list of shame does a grave disservice to Palestinian children," Jo Becker, advocacy director for children at Human Rights Watch, said in a statement Tuesday. "The secretary-general's continued unwillingness to hold Israeli forces accountable for massive violations puts many children at risk."
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