The head of the US National Institute of Allergy and Infectious Diseases (NIAID) has called for wider access to mpox vaccines, warning that the virus poses a serious threat to countries hard-hit by HIV such as SA.
“This has the potential to be a really explosive, damaging outbreak in SA, given the HIV epidemic. We need to do our best to get the preventive tools there,” NIAID director Jeanne Marrazzo said.
“We need to jump on this now while we [still] can,” she said in an interview with Business Day.
Marrazzo made her remarks shortly before the Africa Centres for Disease Control (CDC) declared mpox a public health emergency of continental security on Tuesday, a move aimed at helping it co-ordinate an international response to the rapidly spreading virus. The World Health Organisation (WHO) will meet on Wednesday to decided whether to declare mpox a public health emergency of international concern.
Africa is grappling with two outbreaks of mpox that are raising concerns about the spread of the virus, but has few vaccines on hand. Africa CDC director-general Jean Kaseya said the continent needed 10-million doses, but had only 200,000 available.
The Africa CDC said last week that a new and more transmissible strain of mpox dubbed clade 1b, had spread from the Democratic Republic of Congo to at least five other countries, including Rwanda, Uganda and Kenya. SA has an outbreak of the less potent clade 2, which spread around the world last year. However, even clade 2 can cause severe illness and death among people who have a compromised immune system, such as those living with untreated HIV.
We cannot stop innovating. Every time we get an advance people say this is going to be the end of HIV ... but we are still not stemming the tide quickly enough.
The spread of clade 1b was “very worrisome” and SA officials needed to be prepared for its potential spread to SA, Marrazzo said. “Pathogens don’t respect borders,” she said.
SA has the world’s biggest HIV/Aids burden, with an estimated 7.5-million people living with the disease, according to the Human Sciences Research Council’s 2022 HIV/Aids household survey.
The country has recorded 22 cases of mpox since May 8, including three deaths. While the health department has received donations of the mpox treatment Tecovirimat from the WHO it has yet to secure any vaccines.
SA is still in talks with the WHO to secure donations, and is hoping to obtain 40,000 doses, health department spokesperson Foster Mohale said.
Mpox, formerly known as monkeypox, is a viral disease closely related to smallpox that is spread through close contact, causing flu-like symptoms and painful blisters. While it is usually mild and self-limiting, it can cause severe illness and be fatal to people living with advanced HIV.
Marrazzo is visiting SA research sites supported by NIAID, which has been the biggest funder of HIV/Aids research in SA for more than two decades. It provided $92m to SA in the 2023 US fiscal year, dwarfing domestic investments. Much of its support has been directed at projects investigating tools for preventing HIV transmission, including the long-acting injectable cabotegravir. It has also supported research on tuberculosis and other infectious diseases.
“We cannot stop innovating. Every time we get an advance people say this is going to be the end of HIV ... but we are still not stemming the tide quickly enough,” Marrazzo said.
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