The Public Health Agency of Canada is believed to have a stockpile with millions of doses of a smallpox vaccine, which is one of two vaccines to be approved for use against mpox.Jeenah Moon/The Associated Press
Canadian health officials say they have no plans to share Canada’s stockpile of the mpox vaccine with countries in Africa that urgently need millions of doses to fight a fast-spreading outbreak of a dangerous new variant of the virus.
At least 10 million doses of mpox vaccines are needed across Africa, where the viral illness has caused more than 450 deaths in the past eight months, but only about 200,000 doses are currently available, the African Centres for Disease Control and Prevention (Africa CDC) says.
“This is a major issue,” said Jean Kaseya, director-general of Africa CDC. “We need to have vaccines. We have a limited availability of vaccines, and it is a major challenge.”
Africa CDC declares health emergency over mpox, warns of ‘global threat’ as virus explodes
The Africa CDC is seeking help from international partners, since the outbreak could escalate into “another pandemic” affecting all countries, Dr. Kaseya said at a media briefing last week. “We don’t want to see the world being affected again as it was during COVID.”
The Public Health Agency of Canada (PHAC) is believed to have a stockpile with millions of doses of a smallpox vaccine, which is one of two vaccines to be approved for use against mpox. It has signed a series of purchase agreements with the vaccine’s manufacturer, Bavarian Nordic, including a contract extension in 2022 that expands an earlier supply contract up to a potential value of US$470-million.
The agency has not officially disclosed the size of its current stockpile, but Health Canada’s website says the vaccine is currently available to high-risk Canadians through local immunization programs. The manufacturer has also sold vaccines to the United States and at least one undisclosed European country.
Nicholas Janveau, a spokesperson for PHAC, said the agency has no plans to provide any of Canada’s vaccines to other countries. It has not received any formal requests from any governments or international health agencies, he told The Globe and Mail in response to questions.
In addition, Canada cannot donate any vaccines to other countries unless PHAC officially declares that it has a surplus beyond the country’s requirements, which it has not done, Mr. Janveau said. But he said Canada is “exploring avenues” to help the response to the mpox outbreak in other ways.
Reported cases of the viral illness, formerly known as monkey pox, have surged by 160 per cent in Africa this year, compared to the same period last year, the Africa CDC says.
The vast majority of the 38,500 mpox cases since 2022 have been recorded in the Democratic Republic of the Congo, but the outbreak has recently spread to 14 other African countries. Cases have been reported for the first time in Burundi, Kenya, Rwanda and Uganda within the past month.
Some of the African cases are a new mutation, known as Clade 1b, which has a much higher death rate and can spread through routine close contact, including from mothers to children. The vast majority of deaths this year have occurred among children.
To bolster its response to the mpox outbreak, the Africa CDC plans to declare a public-health emergency in Africa this week, Dr. Kaseya said. The World Health Organization is also convening an expert committee this week to decide whether to declare a global emergency. An earlier outbreak of mpox in West Africa in 2022 led to a global epidemic.
Health activists say the mpox vaccine issue is an echo of similar controversies during the COVID-19 pandemic, when wealthy countries were accused of hoarding huge stockpiles of surplus vaccines at a time when millions of people in poorer countries were falling sick because of vaccine shortages in their countries.
Critics say the Canadian government should be doing more to share its vaccines. “It shows that all the lessons of COVID have not been learned, particularly by higher-income countries and pharmaceutical companies that play God, deciding who should get priority access in a pandemic,” said Fatima Hassan, a South African human-rights lawyer and founder of the Health Justice Initiative.
“It’s disheartening,” she told The Globe. “Should Canada be sharing? Yes, they should. They probably won’t. Their self-interest and nationalism will prevail.”
The situation, she said, is an “exact replica” of the COVID-19 pandemic: “Companies deciding which countries they will first sell to, prioritizing certain customers, and countries such as Canada and the U.S. hoarding or over-ordering, not sharing, talking equity but not practising equity.”
Adam Houston, medical policy and advocacy adviser at Doctors Without Borders Canada, noted that Canada was one of the first countries to build a stockpile of the Bavarian Nordic vaccine, with contracts dating back over 15 years.
“Now we see countries like the United States pledging doses, but need in countries like Congo still drastically outstrips what is being made available,” he told The Globe.
“Particularly given Canada’s abysmal record on vaccine hoarding, not just for COVID-19 vaccine but during previous outbreaks like H1N1 in 2009, it would be helpful to know what Canada plans to do with its stockpiles.”
The World Health Organization, at a briefing last week, said it is grateful for mpox vaccine donations from Japan, the United States, the European Union and some manufacturers.
It announced the launch of a process for emergency use listing for the two authorized vaccines, including the Bavarian Nordic vaccine, to make it easier to distribute doses in poorer countries where regulatory studies are slower.
In a statement last week, more than two dozen global health experts said the world’s response to the latest mpox outbreak has been “wholly inadequate.” Access to vaccines, tests and treatments in Africa has been completely insufficient, they said.
So far, they said, only 50,000 vaccine doses have been sent to Congo, which has a population of more than 100 million.
“The lack of funding to date is likely a contributing factor to this now expanding outbreak,” the health experts said.
To reduce its reliance on donations, Africa must begin manufacturing its own vaccines, Dr. Kaseya said. “Local manufacturing of vaccines and medicines will be the second independence of Africa.”