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."