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."