High cost of mpox vaccine hinders Africa's efforts to contain outbreak

With costs of mpox vaccines sky-high, Africa’s leading health agency is seeking donations to secure four million vaccine doses needed to fight the outbreak across the continent over the next six months.

So far this year, nearly 25,000 cases of mpox, including 643 deaths, have been reported across Africa, with the outbreak originating in the Democratic Republic of the Congo and spreading to over a dozen other countries.

Vaccine supplies are urgently required considering the severity of the situation, but the skyrocketing costs have posed a significant affordability barrier for countries already struggling with multiple health crises including cholera, measles, malaria, and HIV.

According to the reports, manufacturers are charging up to US$140 per dose, making the vaccines unaffordable for most African nations, which now rely heavily on donations mostly from Western nations that have large stockpiles. Bavarian Nordic, a leading manufacturer of mpox vaccine, has been identified as a key supplier of as many as 12 million doses by 2025, as part of a procurement plan by global health agencies to address the mpox outbreak.

“The Africa Centres for Disease Control has pegged the price for Bavarian’s vaccine at $100 per dose, while the World Health Organization quoted it at $141. That’s more than what most countries on the continent can afford,” as Bloomberg reported.

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“Pricing is a problem,” Bloomberg quoted Helen Rees, chair of the WHO’s African advisory group on immunisation as saying. The price has put the jab among the treatments where “the cost is going to make things prohibitive,” she added.

A pricing model used by global vaccine alliance Gavi has previously beaten down the cost of shots by securing large volumes, making it viable for manufacturers and helping ensure products get where they need to be. But at this stage, Bavarian’s mpox jab doesn’t fit that structure, she said.

“In this kind of circumstance, you’ve got limited supply and a manufacturing side of things that is expensive – this is not a cheap product to make,” Rees said. “There’s a real cost associated.”

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WHO emergencies chief Mike Ryan highlighted the staggering cost of vaccinating large populations: “If you want to vaccinate five million people in Congo, that’s going to cost you a billion dollars.” The DRC’s health minister, Samuel-Roger Kamba, emphasized the urgent need for 3.5 million doses, while the entire African continent requires 10 million to halt the outbreak.

Wealthier countries like the United States, which has stockpiled approximately 7 million doses, and Spain, with 2.5 million doses, are well-positioned to launch vaccination campaigns in the event of outbreaks. However, Africa’s limited access to vaccines has hindered efforts to contain the spread of mpox. Since the start of 2024, the continent has reported 5,549 confirmed mpox cases, with 643 deaths. The DRC remains the epicenter, accounting for 91% of the total cases.

In the event of an outbreak, these rich nations can promptly launch vaccination campaigns to protect their citizens, as seen during the 2022 US mpox outbreak, where over one million shots were distributed by year’s end. As the Democratic Republic of Congo received its initial batch of mpox vaccines, talks facilitated by agencies like Unicef are ongoing to secure additional vaccines for crisis-stricken African countries, with initial agreements expected to be finalized by mid-September.

The Congo remains the outbreak’s epicenter, which has spread to neighboring countries and beyond, but the lack of vaccines in Africa has hindered efforts to contain the disease.

Since the start of 2024, there have been 5,549 confirmed mpox cases across the continent, with 643 associated deaths, representing a sharp escalation in both infections and fatalities compared to previous years. The cases in Congo constituted 91% of the total number. Most mpox infections in Congo and Burundi, the second most affected country, are in children under age 15.

WHO Director-General Tedros Ghebreyesus has called on countries with stockpiles of vaccines to work with us and our partners to get those vaccines to where they are needed now.