Alliance statement on mpox global health emergency

The Australian Global Health Alliance (Alliance) is deeply concerned about the uncontrolled and accelerating multi-country outbreak of mpox in African countries, centred in the Democratic Republic of Congo (DRC) but spreading rapidly internationally. The Alliance calls on the Australian Government to expedite resources towards mobilisation of an effective, internationally coordinated and equitable response that will contain this outbreak, accelerate research, and safeguard vulnerable populations in the region.

Wealthy countries like Australia must be both compassionate and smart. The first and best response for Australians is to support international efforts to limit the impact and spread of the disease where it is currently at its worst. Specifically, we call on the government to:

1. Provide direct support to contain the response in the African region, including via direct vaccine contributions, and supporting lead multi-lateral agencies.
2. Support countries in our region through preparedness, prevention and early detection of mpox – ensuring they can meet obligations in the IHR through surveillance and response; and have the means to deploy vaccines, engage priority populations at risk and respond to outbreaks. We acknowledge the important work already underway in the Pacific and Southeast Asia to build pandemic resilient health systems as part of the Australian Government’s Partnerships for a Health Region initiative.
3. Support the neglected pipeline of research and development in new tools for mpox and priority pathogens with epidemic and pandemic potential, and enhance efforts to overcome bottlenecks in development and deployment of these tools globally. This is where Australian medical research can make a major contribution.
4. Rapidly mobilise cross-portfolio government advisory groups, such as the Human Animal Spillover and Emerging Disease Scanning (HASEDS) group, and engage with Australia’s Mpox Taskforce, recognising the cross-portfolio nature of the response and while the new Australian CDC is still being formed. Linking departments of health and foreign affairs in all countries will also be crucial for effective response.
5. Support all measures to protect vulnerable people and prevent stigmatisation, particularly of gay, bisexual and other men who have sex with men, and migrant communities in the response

On August 14th 2024, following the advice of an IHR Emergency Committee of independent experts, World Health Organization’s (WHO) Director-General Dr. Tedros Adhanom Ghebreyesus declared mpox a Public Health Emergency of International Concern (PHEIC) under the International Health Regulations (2005)[i]. WHO has not declared mpox a pandemic, rather the measures triggered by a PHEIC are designed to prevent this.

The current PHEIC declaration is the second time the disease has reached this level of concern. In 2022 an outbreak occurred in Europe and spread globally, affecting 111 countries before being controlled in May 2023 through rapid mobilisation and risk reduction among gay and bisexual men. This initial global outbreak is, however, ongoing with an uptick in 2024 and caused by a variant called clade II, predominantly affecting men who have sex with men and immunocompromised individuals.

This second PHEIC has been triggered by the emergence of a highly infectious strain last year, clade 1b, which is of high concern as it is spread more easily to close contacts and has a higher mortality rate[ii]. In the last six months alone, the number of reported cases has surged to 15,600 cases and 537 deaths – exceeding the total cases reported to WHO for all of last year.[iii] This clad disproportionately affects children, with almost 70 per cent of cases[iv] and 85% of recent deaths[v] having occurred in children under the age of 15.

Despite the rapid increase in cases, there is insufficient access to tests and treatments, and the Africa CDC estimates that currently 200,000 doses of mpox vaccines are available from a need of 10 million doses[vi]. The WHO has triggered the process for Emergency Use Listing of mpox vaccines and developed a regional response plan that requires at least an initial US$ 15 million to support surveillance, preparedness and response activities. Community engagement and workforce support will be vital given the vulnerability of communities and health systems in the African region

The 2022-23 global mpox outbreak stemmed from the international community’s neglect and failure to respond swiftly and invest in equitable surveillance and research, despite regular outbreaks in Africa that eventually led to the disease’s spread to other continents. To prevent a repeat of history and learn from past lessons, we must act decisively to scale and coordinate our global efforts, working closely with the international global health community, including WHO and the Africa CDC, to support affected countries in containing the spread of this disease.

We support the open letter by The Independent Pandemic Panel for Pandemic Preparedness and Response which calls for[vii]:

• Political attention and leadership at national, regional, and global levels to save lives, address gendered impacts, stigmatisation and discrimination and stop the spread.
• Millions more dollars in international funding to be made available to work with communities to contain this outbreak. The lack of funding to date is likely a contributing factor to this now expanding outbreak.
• Immediate increased access to more testing, and provision of millions of doses of vaccines to ensure protection of people at risk.
• Effectively engage with and work in partnership with communities to contain this outbreak and leave no one behind – particularly those at risk to promote prevention measures, vaccine uptake, contact tracing and care to those affected.
• Enhanced surveillance to track and understand the spread of this outbreak and better target the response.
• Massively increased Investment in research and development and support for Africa-based researchers to learn more about all aspects of mpox and develop locally-based and tailored solutions.

Australia and the global health community must uphold the principles of equity and solidarity in making a meaningful contribution to a coordinated international response that will stamp this health emergency and prevent another pandemic. The response in the first 100 days needs to be urgent and swift as any delay to act effectively will have greater international and national costs.

The Australian Global Health Alliance and its members are committed to supporting the Australian government in its efforts to respond effectively.

 

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[i] https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern

[ii] https://mailchi.mp/ipppr/jointopenletter-17387515?e=[UNIQID]

[iii] https://www.who.int/news/item/14-08-2024-who-director-general-declares-mpox-outbreak-a-public-health-emergency-of-international-concern

[iv] https://africacdc.org/wp-content/uploads/2024/07/MPox-Situation-in-Africa.pdf

[v] https://mailchi.mp/ipppr/jointopenletter-17387515?e=[UNIQID]

[vi] https://www.gavi.org/vaccineswork/will-vaccines-help-stop-mpox-outbreak-africa

[vii] https://mailchi.mp/ipppr/jointopenletter-17387515?e=[UNIQID]