The World Health Organization (WHO) has announced a comprehensive global strategy to stop the spread of MPOX, formerly known as monkeypox. The new plan, released Monday, focuses in part on a “strategic vaccination” campaign aimed at curbing the spread of the virus. The effort will run from September 2024 to February 2025 and will be supported by a $135 million fund.
WHO Strategic Plan
According to an executive summary of the plan called the Global Strategic Preparedness and Response Plan (SPRP), the global monkeypox outbreak that began in 2022 has resulted in more than 100,000 confirmed cases in 116 countries. The “rapid spread” of the lineage 1b strain and its variants (lineage 1a, lineage 2, etc.) in the eastern Democratic Republic of the Congo (DRC) and neighboring countries, as well as its detection in Sweden and Thailand, was interpreted by the WHO as an “evolving threat” and led to the declaration of a Public Health Emergency of International Concern (PHEIC) on 14 August 2024.
The WHO's new plan provides a framework for action that focuses on “enhanced surveillance, timely detection and rapid response” in high-risk areas.
The plan includes a “strategic vaccination effort” for those most at risk, such as close contacts of recent cases and health care workers, and calls for global cooperation to “increase access to vaccines,” particularly in low- and middle-income countries.
The declared primary goal of the plan is to “prevent the occurrence of human-to-human transmission of MPOX and mitigate its impact on human health through coordinated efforts at the global, regional and national levels.” This should be achieved through “harmonized strategies, collaborative decision-making and transparent information sharing,” which is probably a euphemism for global governance by WHO bureaucrats.
Geography of diffusion
The WHO has identified different risk levels for MPOX in different regions.
Eastern Democratic Republic of the Congo and neighbouring countries: There is high risk from the rapid spread of lineage 1b mpox virus, especially among vulnerable groups such as internally displaced persons and sex workers.
Endemic areas of the Democratic Republic of the Congo: Risk from clade 1a mpox virus remains high, affecting mainly children through various routes of transmission.
West, Central and East Africa: Lineages 1 and 2 continue to circulate, posing a moderate risk to both children and adults.
Rest of the world: There is a moderate risk from imported cases and community transmission of lineage 2b, especially among men who have sex with men (MSM).
It is these countries and territories that WHO is targeting in its planning.
Vaccination efforts
In dealing with the monkeypox “emergency,” the WHO has focused on costly and questionable strategies such as vaccines, which it considers an “essential element” of global preparedness and response.
No vaccine has been prequalified or granted emergency use authorization by the WHO, but the organization is “considering” several vaccine candidates, including MVA-BN, the only monkeypox vaccine currently approved in the U.S., Switzerland, Canada, the EU and the U.K. In the U.S., it is marketed as JYNNEOS.
It was originally approved by the U.S. Food and Drug Administration (FDA) for adults 18 years of age and older who are at high risk for smallpox and monkeypox.
However, during the 2022 monkeypox outbreak, citing vaccine supply constraints, the FDA expanded the Emergency Use Authorization (EUA) for JYNNEOS to allow its use in a broader population, including those under 18 years of age, and to allow alternative dosing strategies. Thus, while JYNNEOS has full FDA approval for its specific use, the expanded EUA allows for broader application in response to public health emergencies and provides the vaccine manufacturer with legal immunity for side effects.
Other candidate vaccines on the WHO list include LC16m8, used primarily in Japan for both smallpox and monkeypox, and ACAM2000, which has received emergency use authorization in the U.S. An FDA warning states the vaccine may cause myocarditis and other heart problems.
In addition to these, the WHO is looking at BioNTech's monkeypox mRNA vaccines currently in preclinical research. These include BNT166a and BNT166c, both of which are being developed in collaboration with the Coalition for Epidemic Preparedness Innovations (CEPI), which is funded by vaccine enthusiast Bill Gates.
It's a strong sense of déjà vu, but the WHO optimistically states that these “next-generation mRNA vaccines…have demonstrated robust immune responses and complete protection in challenge trials, showing promising preclinical results.” BioNTech's vaccine is said to be “designed to provide broad protection against MPXV and related orthopoxviruses.”
The WHO has stressed the need to “scale up global production and distribution” of vaccines to meet expected “demand,” especially in low- and middle-income countries. This includes “accelerating the regulatory evaluation of both new and existing vaccines,” which implies rapid evaluation of vaccines, but as the COVID-19 pandemic has demonstrated, this inevitably compromises the thoroughness required for such evaluations and makes long-term safety evaluation impossible.
The WHO also stresses the importance of building public trust in new vaccines through “effective communication and community engagement” to achieve “high vaccination coverage.”
Finally, the WHO is focusing on developing and deploying a “pan-orthopoxvirus vaccine” that could target multiple related viruses and reduce the risk of “future epidemics.” Still, as with COVID vaccines, the plan notes that booster shots may be needed because the immune response may not be as sustained as hoped.
The main targets of “strategic vaccination” are said to be “individuals at significantly higher risk of infection, including close contacts such as family members and sexual partners of people confirmed to be infected.”
Risks and infection routes
It is important to remember that the monkeypox virus is not easily transmitted between most populations. Person-to-person transmission occurs primarily through direct contact with infected wounds, scabs, or body fluids. It can also be transmitted by respiratory droplets during prolonged face-to-face contact, or by touching contaminated objects or surfaces.
According to the US Centers for Disease Control and Prevention (CDC), in the recent outbreak, “the primary route of transmission was associated with sexual activity among certain gay, bisexual, and other men who have sex with men (MSM).”
The disease causes symptoms such as fever, headache, muscle and back pain, swollen lymph nodes, chills, and fatigue, and may then develop a rash on different parts of the body.
Monkeypox is generally considered to be less severe than smallpox, but it can be fatal in people with significant underlying medical conditions, such as a severely weakened immune system, including untreated HIV/AIDS or other immunosuppressive conditions.
During the 2022 outbreak, the CDC recorded more than 32,000 cases of monkeypox, 58 of which were fatal.
There is no specific treatment for monkeypox, but the disease can be effectively managed through supportive care, antiviral treatment, and preventive measures.
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