The World Health Organization (WHO) appealed for support this week by declaring the latest mpox outbreak in Africa an international health emergency. Trouble is, there are scant funds currently available to tackle the potentially lethal virus.

Curbing the spread of mpox in the Democratic Republic of Congo and neighbouring countries will require campaigns of surveillance, public health education and vaccination that will be expensive, particularly for the impoverished nation at the centre of the crisis. 

So far, the WHO has released US$1.45 million from its contingency fund for emergencies, while the African Union has approved US$10.4 million from its existing Covid funds for the Africa Centres for Disease Control and Prevention (CDC). The largest sum could come from Gavi, the Vaccine Alliance, which has said it could tap into its new US$500 million emergency fund for vaccinations.

That’s far short of the US$4 billion the Africa CDC’s director general, Jean Kaseya, estimated the continent will need to combat mpox.

“The big gap I can clearly see here where we will repeat the mistakes of the past is not having a surge financing mechanism,” said Javier Guzman, the director of global health policy at the Center for Global Development, a non-governmental organisation that focuses on public health, in an interview. The only substantial option at the moment is the funding from Gavi, which could be used for vaccinations, but it is “far from adequate”, he said. 

The surge of cases is centred in Congo, a country roughly the size of Western Europe that’s been wracked by a decades-long conflict, severe poverty and malnutrition. Add to that the presence of some 4.2 million internally displaced people, many staying in crowded camps, and the challenge of halting the spread becomes even more challenging. 

Already this year, there have been about 15,700 suspected cases, resulting in around 550 deaths, according to the Congolese government. While many of those are due to an older, less contagious mpox variant, there’s concern that infections from the newer variety will rise rapidly.

Congo alone has said it requires 3.5 million vaccine doses, and its public health minister, Roger Kamba, put the cost at hundreds of millions of dollars. The price of the shots has been estimated at US$100 a dose, unaffordable for many countries. In a briefing on Thursday, Kamba urged the international community to provide assistance.

The challenge in securing money to fight the mpox outbreak is playing out against a backdrop of very limited funding for a range of deadly diseases, said Peter Sands, an executive director of the Global Fund to Fight AIDS, Tuberculosis and Malaria. 

There are “massive gaps in financing diseases that are already killing a lot more people”, Sands said in an interview. While more funds might be needed, he cautioned against forgetting the wider context of a shortage of funding for diseases like malaria in Congo.

In the case of mpox, one of the quickest ways to get financing where it needs to go is to re-purpose funding from mechanisms that already exist, such as work on disease prevention, said Sands, who was previously the chief executive officer of Standard Chartered plc. 

In Congo, large gaps remain in knowledge about the epidemiology of the disease. The declaration of a global health emergency better focuses attention on understanding the infection and how it is spreading in Congo. “We don’t really have a grip on it terms of the epidemiological dynamics, and this will focus attention on that quite effectively,” he said.  

  - Bloomberg