site.btaMpox: WHO Seeks USD 135 Mln to Battle New Variant, Experts See “Low Risk” for Europe

In mid-August, the World Health Organization declared the highest level of alarm due to mpox outbreaks in a number of African countries and a new, potentially more dangerous variant. While the risk in Europe is low according to the European Centre for Disease Prevention and Control, calls for solidarity and vaccine sharing emerge. 

On August 13, the Africa Centres for Disease Control and Prevention (Africa CDC) declared mpox – formerly monkeypox – to be a continent-wide public health emergency and asked for international help in achieving its target of providing two million vaccines

The World Health Organization (WHO) one day later declared the highest level of alarm due to the mpox outbreaks in Africa and a potentially more contagious new variant but advised against panic following the first imported case in Europe. 

The virus causes a rash, fever, and muscle pain. Symptoms are mainly treated by medication to prevent fever, pain or allergic reaction. There are two vaccines, but they are in short supply in Africa. 

Mpox was first detected in humans in 1970, in the Democratic Republic of Congo (DRC) and is considered endemic to countries in central and west Africa.

New variant detected beyond Africa but mpox “not the new COVID”

A new clade – or variant – has been circulating in the DRC since late last year.

According to the WHO, more than 18,000 suspected cases with 575 deaths have been registered in the country this year.

The viral illness has spread to other African countries in recent weeks, including Kenya, Rwanda, Burundi and Uganda which count more than 200 confirmed infections with the new variant Ib. Cases of the variant have also been registered in people in Sweden and Thailand who had travelled to Africa.  

Experts believe the new variant (called clade I) is likely more contagious than previous strains and can cause a more severe infection. However, mpox is generally not easily transmitted, with direct contact needed for spread.

Briefing journalists on August 20, the WHO’s regional director for Europe Hans Kluge said that the virus has been circulating in the region in an earlier, less aggressive variant, known as clade II, since the previous outbreak in 2022. According to Kluge, around 100 cases of this variant are currently occurring per month in Europe and “mpox isn’t the new COVID”. 

“We know quite a lot about clade II already,” Kluge said, adding that “we still have to learn more about clade I“, causing the epidemic in Central and East Africa. 

In July 2022, the WHO announced a first “Public Health Emergency of International Concern” (PHEIC) related to mpox which was declared over in May 2023. During the 2022-2023 outbreak, over 22,000 cases of mpox were reported in Europe. 

On Monday, the WHO estimated that it will need 135 million US Dollars over the next six months to combat mpox, not including the cost of two million vaccine doses, according to a planning paper from the UN health agency. The money is to chiefly be invested in diagnostic tests and research, the WHO said.

No European public health emergency, solidarity is key to tackling outbreak

According to a European Commission spokesperson on August 20, the current situation in Europe shouldn’t “be considered a public health emergency”. The European Centre for Disease Prevention and Control (ECDC) stated in a risk assessment that more imported cases “will likely occur” but considers the risk of the new mpox variant for the general public of the EU/EEA as low.

After a meeting with the ECDC and the European Medicine Agency (EMA), the Health Security Committee of the European Commission concluded that measures such as border controls or extending vaccinations to the general public are not necessary. 

The European Commission has asked member states about their intention to donate mpox vaccines to affected African countries and offered to coordinate the effort. 

Stella Kyriakides, EU Commissioner for Health and Food Safety, on August 22 sent a letter to the EU’s health ministers calling for coordinated action in a “spirit of global solidarity and cooperation” through the Team Europe approach which was also used during the COVID pandemic.

The European Union will send 175,420 doses of vaccines to the Africa CDC to prevent mpox, the European Commission announced in mid-August. 

The commission said in a statement that it would supply the vaccines via its Health Emergency Preparedness and Response Authority (HERA). Pharmaceutical firm Bavarian Nordic, which manufactures the vaccine, will donate 40,000 doses to HERA, the statement said.

On Monday, a German government spokesman said that the country was donating 100,000 doses of mpox vaccine to African countries affected by the disease from army stocks. In the medium term, Germany, together with European partners, will also support the African Union in setting up local vaccine production, he said.

EU countries are preparing themselves

Several European countries are advising their citizens to be vigilant when it comes to travelling to affected areas, implementing measures in case of possible infections while recommendations for vaccinations remain limited to at-risk groups. EU and national health authorities remain calm but alert.

In Sweden, where the first case of the new variant in Europe was detected in mid-August, a special governmental crisis group called GSS had been activated.

“I take the situation seriously, but there is no reason for a major worry. The risk of spreading is low and we have a good preparedness for this, with good routines in the health system,” Sweden’s Health Minister Jakob Forssmed said earlier this month.

Sweden has announced new travelling advice to people that need to visit the most affected countries in Africa, and also recommendations on who might need a vaccine.

“Most people going there do not need to be vaccinated. Vaccination may be relevant for health- and hospital personnel, aid workers or others that will be in the most affected area. We have enough vaccines for anyone covered by these recommendations,” chief epidemiologist Magnus Gisslén told Swedish News Agency TT.

The Czech health ministry said that people travelling to the African countries where the disease has been reported should consult a vaccination and travel medicine centre on the suitability of vaccination and other preventive measures. A spokesman further said that there were enough vaccines available in the country. 

The Spanish Ministry of Health insists that Spain has a sufficient stock of vaccines, too. On August 21, the Minister of Health, Mónica García, sent a message of “calm, caution and scientific rigor” regarding the mpox virus to the people. García further said:  “We are going to go, as always, hand in hand with scientific rigor and the recommendations coordinated at European and global level.”

The Dutch National Institute for Public Health and the Environment (RIVM) expects that the new variant is “probably” also coming to the Netherlands. “As soon as we have a case of the new variant, the person will be isolated and there will be a source and contact investigation. People are on standby for that. We expect to be able to contain the spread quickly,” the RIVM informed. The Ministry of Health, Welfare and Sport stated that there are “around” 100,000 vaccines available, deemed “ample” in view of the infection numbers since the mpox outbreak in 2022. 

The Italian National Institute of Health (ISS) doesn’t currently recommend vaccines for the general population, stating that  “vaccination is currently offered to certain categories of people most at risk”. The country’s Ministry of Health has set up a webpage dedicated to mpox including information on the disease or vaccination strategy and vaccination centres as well as a section on fake news among other subjects. 

The Slovenian National Institute of Public Health (NIJZ) estimates that vaccination of the general population against mpox is currently neither necessary nor recommended. Vaccination is recommended for laboratory workers and highly exposed health workers, as well as for humanitarian workers planning to work in affected areas.

After the first case of the new mpox variant was reported in Europe, Bulgarian health authorities said the risk of the disease spreading in the country was minimal and hence did not foresee further special measures to contain the infection.

The following news agencies have contributed to this story: ANP, ANSA, BTA, CTK, dpa, EFE, STA, TT