The matter is serious. Serious enough that the World Health Organization (WHO) recently declared that the mpox epidemic in Africa is now considered a “public health emergency of international concern”, the highest alert level. The risks of contamination in Canada are currently very low, and our country is equipped to deal with pockets of contamination if there were any. But the same cannot be said of Africa, which, faced with mpox as with COVID-19, demonstrates its state of extreme vulnerability in terms of vaccination capacity. And this, under the all too indifferent eye of the international community.
Although smallpox was eradicated in the 1980s, the mpox virus has been circulating in central and western Africa since 2022. The virus is divided into two main clades (a clade is a group of viruses that come from a similar strain): clade 1, which is considered more dangerous and deadly, and clade 2. Between May 2022 and the end of December 2023, Health Canada has recorded 1,541 cases of mpox (clade 2b). No deaths have been reported. Since the beginning of 2024, there have been 164 cases of type 2b, but no cases of type 1b so far — experts say it’s just a matter of time.
The variant that is causing concern among global health authorities is in fact clade 1b. In Canada, the alert level is not high: not only have no cases of this type been observed, but the country considers that the risk of contracting this smallpox is low.
This is not the case in Africa, which since the beginning of the year has seen an alarming increase in cases, but also in deaths. According to the Africa Centers for Disease Control and Prevention (Africa CDC), more than 17,500 cases and some 500 deaths have been observed since the beginning of the year. “It is alarming to note that the number of cases reported in 2024 has increased by 160% compared to the same period in 2023,” declared on August 17th Cyril Ramaphosa, African Union Champion for Pandemic Prevention, Preparedness and Response.
There are two WHO-authorized vaccines in circulation around the world — Canada has the Imvamune and its stockpile is not lacking. But Africa’s needs are enormous (10 million doses to stem the epidemic), and promises of supplies from other countries or manufacturers do not even come close to 300,000 doses for now. Variant 1b is said to be more deadly in young children — a mortality rate of 11% is reported, compared to 4% in the general population — which is worrying for the affected African countries. The WHO and UNICEF also point out that childhood vaccination rates worldwide are falling.
What have we learned from the COVID-19 pandemic, during which the vaccine fragility of the most vulnerable countries has been a major topic of discussion? From the moment a virus is in circulation and its level of contagion is considered high, the entire planet is at risk of contamination — which is why we are talking so much about COPD here today while it is Africa that is burning.
We will remember the protectionist reflexes shown by all industrialized countries in 2020. Concerned about first protecting their populations, who were in mortal danger, these countries raced among themselves to obtain the greatest number of vaccine doses, totally neglecting the fate of underdeveloped countries, incapable of developing a vaccine themselves or even of purchasing enough doses.
In a text published in The Press In early June, Dr. Joanne Liu, a professor at McGill University’s School of Population and Global Health, noted that “Canada has been one of the biggest vaccine hoarders (an average of five per Canadian) and has been a late adopter of its surplus with looming expiry dates.” As of October 2021, less than 5% of Africa’s population had been vaccinated against COVID. To this day, many countries have still not reached the WHO target of 70% vaccination coverage.
In response to the outbreak of mpox in Africa, Canada announced this week a $1 million donation to the WHO to support the production and purchase of vaccines for the African continent. The request from the Africa CDC was intended to share doses already available to Canada, but Canada has not yet opted for this strategy.
Although Africa aspires to a certain autonomy in terms of vaccine production, it faces challenges of intellectual property and technology transfer, recalls Dr. Liu, referring to the pandemic treaty desired by the WHO, but not yet completed. It seems logical, however, that stopping an epidemic where it starts, as quickly as possible, by providing free vaccination coverage, would help protect all other countries and prevent the pandemic. But there you have it, politicians often have no use for lessons in logic…
