The World Health Organization (WHO) recently declared that the outbreak of Mpox (previously known as monkeypox) in the Democratic Republic of the Congo (DRC), and a growing number of countries in Africa constitutes a public health emergency of international concern (PHEIC).
A PHEIC is “an extraordinary event which is determined to constitute a public health risk to other States through the international spread of disease and to potentially require a coordinated international response.” This definition implies a situation that is serious, sudden, unusual or unexpected; carries implications for public health beyond the affected State’s national border; and may require immediate international action.
Mpox is an infectious disease caused by the monkeypox virus. It can be transmitted through contact with bodily fluids, lesions on the skin or on internal mucosal surfaces, such as in the mouth or throat, respiratory droplets and contaminated objects. Common symptoms include a painful rash, enlarged lymph nodes, fever, headache, muscle ache, back pain, and low energy. Most people fully recover, but some get very sick.
The number of reported Mpox cases has increased steadily over the past decade, with more than 15,600 cases and 537 deaths reported so far this year, the WHO stated. There are two distinct clades of the Mpox virus: Clade I (with subclades Ia and Ib) and Clade II (with subclades IIa and IIb). In 2022-2023, a global outbreak of Mpox was caused by the Clade IIb strain.
Over the past months, an increasing proportion of reported infections have been attributed to Clade I, with the Clade Ib variant first identified in October 2023. This variant is more easily transmitted among humans compared to previous strains and causes more severe disease and has a higher mortality rate, with up to 3.6% of cases resulting in death. In addition, approximately 60% of cases in DRC are in children under 15, rising to 70% when considering those under 18, the WHO said.
To date, the Department of Health (DoH) has confirmed three active cases of Mpox of the milder Clade II variety in the Philippines. This brings the country’s total number of laboratory-confirmed Mpox cases to 12 since July 2022.
The WHO recommends that vaccination against Mpox be considered along with other public health interventions. Getting an Mpox vaccine (pre-exposure prophylaxis) can help prevent infection. It is recommended for people at high risk of getting Mpox, especially during an outbreak. These include healthcare workers at risk of exposure; people in the same household or close community as someone who has Mpox, including children; people who have multiple sex partners, including men who have sex with men; and sex workers of any gender and their clients.
The vaccine can also be administered after a person has been in contact with someone who has Mpox (post-exposure prophylaxis). In these cases, the vaccine should be given less than four days after contact with someone who has Mpox. The vaccine can be given for up to 14 days if the person has not developed symptoms, the WHO explained.
The research-based pharmaceutical industry is deeply concerned about the Mpox outbreak, and we are committed to supporting the global response against Mpox.
“There are several vaccines that might confer some protection against Mpox, and we understand that the companies that manufacture these could further increase production if required,” said Dr. David Reddy, Director General of the International Federation of Pharmaceutical Manufacturers and Associations (IFPMA).
At the moment, there are two approved vaccines which offer protection against Mpox. One of the companies that manufactures Mpox vaccines has informed the Africa Center for Disease Control (CDC) that they have capacity to deliver 2 million doses by the end of this year, and 10 million doses by the end of next year.
Biopharmaceutical companies are also partnering with Gavi (a public-private global health partnership that aims to increase access to immunization in developing countries), the WHO, and Africa CDC to ensure supply and equitable access to vaccines. Subsequently, there are a number of vaccines currently in development against Mpox.
In order for vaccines to effectively be deployed, we also need increased surveillance to inform vaccination strategies, alongside the right regulatory pathways. Furthermore, manufacturers need to receive orders in an efficient way so as to produce output in a timely manner.
Meanwhile, the WHO has published a preliminary landscape of therapeutics licensed or under development while the primary method for diagnosing Mpox is the lab-based PCR test.
“The seriousness of the outbreak serves as another reminder of the importance of supporting the continued development of the vaccines and treatments that are so critical to preparing and responding to global health threats, and that the international community must ensure they can reach the people who need them as quickly as possible,” Dr. Reddy added.
Vaccines, diagnostics, and treatments remain critical to responding to global public health threats. It is essential that we maintain the infrastructure that supports companies to carry out research and development that make these possible.
In responding to and preparing for any future health threats, it is crucial that the global community ensures that the incentives are in place to enable biopharmaceutical innovation to continue supporting mechanisms that equitable access to vaccines, tests, and treatments.
Teodoro B. Padilla is the executive director of Pharmaceutical and Healthcare Association of the Philippines which represents the biopharmaceutical medicines and vaccines industry in the country. Its members are in the forefront of research and development efforts for COVID-19 and other diseases that affect Filipinos.
