Mpox, Africa needs 10 million vaccines by 2025. The EU will donate (maybe) 5% of it

Japan's KM Biologics produces LC16, already marketed internationally but only authorised by Tokyo and 'on an emergency basis' by the Democratic Republic of Congo itself. The third is ACAM200, produced by the Maryland-based multinational Emergent Biosolutions and authorised only by the US FDA. Africa Cdc and Bavarian Nordic have reached an agreement to strengthen the continent's vaccine capacity, with the company committing to supply two million doses by next year and to facilitate the transfer of manufacturing capacity to African countries. In the meantime, the vaccination campaign hangs on the cooperation of rich economies like that of (and in) the EU.

All in all, Brussels said it had put a total of 566,500 doses of the drug on the table for the benefit of African countries, split between some 215,000 vaccines 'donated' by the European Commission and a qu0ta of 351,500 vaccines arriving from EU countries, in response to an appeal by Health Commissioner Stella Kyriakides. In a letter, the Commissioner asked ministers to cooperate in the campaign to supply the vaccine doses.

"The European Commission has ordered and paid for an initial 200,000 doses of vaccine, but has no intention of buying any further spare capacity as this is the responsibility of the member states," says a European Commission spokesperson responsible for vaccine issues, adding that the EU has taken on "10,000 Mpox treatments for those who have already contracted the virus". At the same time, the spokesperson recalls, 'health is primarily the responsibility of the Member States, the Commission has little say in the field of vaccines, beyond coordination and information sharing, as was also the case during the Covid outbreak'.

Hence Kyriakides' exhortation and the first responses of European countries to the donation effort. Brussels does not specify in its note the quotas envisaged by the individual member states, but the package of more than 350,000 vaccines 'offered' by the member states consists of the doses from a total of nine out of 27 member states: France, Germany, Spain, Malta, Portugal, Luxembourg, Croatia, Austria and Poland. The majority of the stock seems to be attributable to France, Germany and Spain: Paris and Berlin have announced the equivalent of around 100,000 doses each, Madrid had gone so far as to talk of a block of 500,000 vaccines, but it is not clear when they will be delivered and whether they fall within the scope of EU donations. Other governments, such as those of the Netherlands and Lithuania, have stocks but have decided to refrain from donating.

The reluctance exhibited by some European governments is far from isolated, even among partners that would boast far greater reserves than those on a European scale or among individual Member States. Japan is discussing a donation of 2 to 3 million doses of 'its' L 16, against a total allocation estimated by Reuters at 200 million doses. Canada has agreed to around 200,000 doses out of a total of two million, according to the British agency's reconstruction. The US has not disclosed the current supplies, but there is talk of around 100 million doses of the Emergent BioSolutions vaccine alone in addition to the - unspecified - stocks of Bavarian Nordic. According to Think Global Health, a study centre that maps the distribution of the drug, the outcome is a total budget of between 2.7 million and around 3.7 million doses 'promised' to African governments. From the Africa Cdc comes confirmation of the estimate.

The quantity could grow further with the latest targets advertised by Bavarian Nordic itself. The company announced in a note that it intends to increase its supply to at least '13 million doses by 2025', with two million doses expected as early as this year. Should the regulatory authorities give the green light to further 'measures', the company predicts production increases to peaks of 50 million doses.

The scale of the exploit is reduced when faced with one of the biggest obstacles, price. Although Bavarian spoke of 'equitable' access to the drug, its market costs are deemed unaffordable for most sub-Saharan governments. According to estimates released by the Bloomberg news agency, the price per dose could range from around $100 to $140 per dose: a range that makes its purchase 'fair' only or mainly for high-income economies. The same ones that already have the doses and should, or could, share them with sub-Saharan ones.

*This article is part of the Pulse project and was written by Alberto Magnani (Sole 24 Ore, Italy), György Folk (EUrologus / HVG), Lithuania. Contribution by Ieva Kniukštienė (Delphi).