As Case Numbers Climb from Deadly Mpox Outbreak, Direct Relief Secures Critical Vaccine Donation

In response to the current mpox outbreak, which has recorded more than 15,000 cases worldwide and resulted in 500 deaths since the start of 2024, Direct Relief is preparing to increase humanitarian vaccine access along with other critical medical resources to countries and populations most impacted by the disease.

On August 14, 2024, the World Health Organization (WHO) declared the mpox outbreak in Africa a public health emergency of international concern.

Direct Relief's Response

On Monday, Emergent announced that Direct Relief would receive a donation of 50,000 doses of a vaccine for mpox, as well as diluent solution, needles, and syringes required for administration. The donation includes 50,000 doses of ACAM2000®, (Smallpox (Vaccinia) Vaccine, Live) for potential deployment across often difficult-to-reach locations, and as informed by local and regional health authorities.

Direct Relief is preparing to send the vaccines and other aid to health facilities and organizations in impacted countries that include the Democratic Republic of Congo (DRC), Burundi, Kenya, Rwanda, Uganda, and others. Direct Relief is working with the Africa Centers for Disease Control and Prevention and other organizations to coordinate in-country storage, logistics, and distribution of the vaccines.

The vaccine will require ultracold temperature transport of -15 °C throughout shipment, and cold storage upon arrival. Direct Relief specializes in cold-chain medication transportation and logistics, and built robust cold-chain storage capabilities during the Covid-19 pandemic, which required temperature-sensitive vaccine and medication management.

Direct Relief is also in communication with other manufacturers of vaccines for mpox, as well as other companies that manufacture mpox non-vaccine products. The organization is also assessing the need for additional medical aid to support vaccine administration, including portable ultracold storage units. Equipment for disease prevention and treatment, including personal protective equipment such as masks, gloves, goggles, and gowns, is also being offered to support vaccination efforts.

New Variants Prompt Another Global Health Emergency

Mpox saw an outbreak from 2022-2023 in multiple countries and was declared a global emergency. The current outbreak is believed to have been caused primarily by new variants considered to be more virulent than the one responsible for the 2022 outbreak. Mpox transmission occurs through close contact with infected animals, exposure to bodily fluids, and skin-to-skin contact, including sexual activity.

Since the beginning of 2024, more than 15,000 cases and more than 500 deaths have been reported, with most of the transmission focused in the Democratic Republic of Congo (DRC), and neighboring countries in central Africa.
Outside of the continent, cases of the newer variant of mpox have also been recorded in several countries.

The current outbreak has had a disproportionate impact on vulnerable populations, including children. According to the Africa Centers for Disease Control and Prevention, children under 18 comprise approximately 70% of cases in the DRC, with those under 15 accounting for 85% of fatalities. Low immunity to the disease and prevalence of malnutrition could put children at increased risk. Also at heightened risk are displaced people in refugee camps in eastern DRC due to increased transmission risks associated with overcrowding and inadequate sanitation, and healthcare workers, particularly in areas with limited access to personal protective equipment.

Mpox has been reported in the DRC for more than a decade, and the number of cases reported each year has increased steadily over that period, according to a statement from the World Health Organization. The WHO reported that over 100 laboratory-confirmed cases of the new variant, known as clade 1b, have been reported in four countries neighboring the DRC that had not reported mpox before: Burundi, Kenya, Rwanda, and Uganda.

The WHO Director-General triggered the process for Emergency Use Listing for mpox vaccines, which will accelerate vaccine access for lower-income countries which have not yet issued their own national regulatory approval, according to the statement.

Emergent, which is providing the 50,000 vaccine dose donation to Direct Relief, has submitted an Expression of Interest for the vaccine to be added as an Emergency Use Listing, according to a statement from Emergent published this week.

Past Outbreaks, Experience Guide Emergency Approach

Beyond response in Africa, Direct Relief is also strategically positioned to respond globally with cold chain support, and has standing agreements with coordinating regional agencies across the world, including the Pan American Health Organization (PAHO), the Association of Southeast Asian Nations (ASEAN), International Office for Migration (IOM), Caribbean Disaster Emergency Management Agency (CDEMA) and more.

Direct Relief has an extensive track record addressing infectious disease outbreaks globally - from Dengue Fever, to Emergency Use Authorization Covid-19 vaccines and therapies, to Ebola in various parts of Africa, as well as shipping cold-chain and ultra-cold-chain prescription medication shipments globally.

The organization has also worked in Africa for decades, including during the Ebola epidemic, during which the organization was one the world's largest providers of PPE to protect health workers treating patients with the highly virulent disease.

Direct Relief maintains an office in South Africa, and has staff in Africa that coordinate ongoing shipments to more than 35 countries.

Direct Relief's Tom Roane and Rachel Green contributed to this report.

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