Geneva– Gavi, the Vaccine Alliance continues to be deeply concerned about the escalating mpox emergency on the African continent. We welcome recently announced measures by our partners at the African Centres for Disease Control and Prevention (Africa CDC) and World Health Organization (WHO) which will help create an enabling environment in support of a comprehensive region-led response, and join partners in emphasizing the importance of international coordination following a declaration of a Public Health Emergency of Continental Security by Africa CDC and a Public Health Emergency of International Concern by WHO.

Working in collaboration with countries and partners, Gavi has been closely monitoring the mpox situation since 2022. As a result, considerations related to mpox have helped inform both the design of Gavi’s new innovative health security mechanisms, aimed at addressing systemic gaps exposed during the COVID-19 vaccine response, as well as Gavi’s next five-year strategy. When the assessment process for Gavi’s next five-year Vaccine Investment Strategy (VIS) began in 2023, mpox vaccines were included for consideration. Special sessions of the VIS Steering Committee were convened in Q1 2024 to ensure the approach took into account developments in the Democratic Republic of the Congo (DRC), where the outbreak has spread rapidly, primarily impacting children (in terms of both morbidity and mortality), and resulting in a high case fatality ratio.

Also Read: WHO declares Global Emergency over mpox outbreak. Here’s all you need to know.

As a result, in June 2024 the Gavi Board approved the following measures related to mpox:

• In its next five-year strategic period, beginning 2026, Gavi will establish a global stockpile of mpox vaccines – similar to its existing stockpiles for cholera, Ebola, meningitis and yellow fever vaccines. Establishment of a stockpile is pending the availability of WHO Emergency Use Listing or prequalification of a recommended vaccine, and subject to fundraising for Gavi’s next strategic period. A robust assessment of the long-term public health need will inform the design of the stockpile.
• In the interim, Gavi will support outbreak response in the DRC and surrounding countries. More details on this are available below.
• In parallel, Gavi will make critical investments in a learning agenda that will ensure the current response will help inform and improve future vaccination efforts against the disease, including the design of a global stockpile.  More details on this are available below.

Africa CDC declares Mpox a public health emergency of continental security

Support to the ongoing emergency and response efforts

Gavi has been monitoring the mpox situation daily for the past several weeks, and is currently engaging closely with countries, Africa CDC, WHO, UNICEF, donors, and manufacturers to support the response to mpox. Our actions include:

• Rapid operational support: As an immediate measure, Gavi has formally declared the mpox situation a regional emergency and has initiated a process to expand this to the region. This allows them to trigger certain additional flexibilities and streamline processes, underpinned by a no-regrets approach to risk.
• Leveraging new innovative mechanisms to support the overall response: In June 2024, the Gavi Board also approved the final terms of the First Response Fund, the fastest tool in a suite of instruments called the Day Zero Financing Facility, which – in response to a key learning from COVID-19 – seeks to make resources immediately available for a vaccine response to an urgent public health emergency.
• Direct procurement: Gavi has accelerated engagement with manufacturers, including Bavarian Nordic, for potential direct procurement of mpox vaccines in support of outbreak response.
• Dose donations and emergency response: Building on the unique experience of working with 33 donors to coordinate the supply of nearly 1 billion dose donations to 114 countries in response to COVID-19, Gavi will offer direct support and share knowledge with countries and partners as requested, while working with them on designing in-country vaccination strategies.
• Investing in a learning agenda: Following the June 2024 Board decision, Gavi has moved to ensure any vaccine response for mpox will also help improve the data available on disease burden and epidemiology, including through supporting surveillance studies and modelling studies on vaccine use and impact.