The world has a new weapon to fight mpox

Two years ago, in the same region of the Democratic Republic of the Congo (DRC) that is currently the epicentre of the Bundibugyo Ebola disease outbreak, an outbreak of a different kind was causing global concern.

The mpox emergency of 2024 made headlines around the world, with cases detected in more than 90 countries, including in the UK. Today, new mpox outbreaks remain a global threat. However, last week, with the launch of the first ever strategic stockpile of mpox vaccines, the world took a decisive step towards keeping that threat in check.

Vaccines are one of the most effective tools for controlling disease outbreaks and preventing their international spread. The most effective response to a disease outbreak is a rapid response, but accessing and deploying vaccines during outbreaks can be extremely challenging. By ensuring a physical supply of vaccines is ready to draw down at a moment’s notice, stockpiles help stop outbreaks in their tracks.

Stockpiles are also vital because they help to smooth out the unpredictable demand that would otherwise make the production of some vaccines unsustainable. Without stockpiles, the scramble to access a sufficient supply of vaccines results in inevitable delays, costing lives and increasing the risk of uncontrolled spread across borders. By managing these stockpiles at the global level we can ensure that vaccines are accessible by every country in the world. This is a global good: ensuring every country has rapid access to vaccines makes every country safer. 

The mpox vaccine stockpile takes its place alongside other stockpiles funded by Gavi, the Vaccine Alliance, against cholera, yellow fever, meningococcal disease and the Zaire species of the Ebolavirus, all of which have been drawn on in recent years. In fact, the number of times these stockpiles have been required has continued to accelerate year on year. 

Last year set a new record, with more than 60 outbreaks requiring the emergency deployment of vaccines. The underlying reasons for the increasing trend are complex. Climate change, conflict, fragility and the effects of vaccine misinformation all play a role. Recent cuts to international aid for health programmes will undoubtedly increase the vulnerability of already fragile health systems. We can therefore expect the strategic importance of vaccine stockpiles to continue to increase over time. 

Stockpiles are vital, but what happens when there is an outbreak of a disease for which we haven’t yet established a vaccine stockpile? Or worse still, for which there isn’t yet an approved vaccine? In both cases rapid access to cash on hand is critical, either to purchase vaccines directly or to incentivise and accelerate their development. Gavi’s surge financing mechanism – the First Response Fund (FRF) – fulfils both of these functions, meaning that today, Gavi can rapidly access funds to accelerate emergency access to vaccines, rather than appealing for funds and waiting for donors to mobilise financing, as was the case in the past  

During the mpox outbreak in 2024, the FRF was used for the first time to ensure half a million vaccine doses could be rapidly purchased and shipped to the DRC and other affected countries.  And today the FRF is playing a key role in the response to the DRC’s Ebola epidemic by making up to US$ 40 million available to accelerate the development and deployment of new vaccines against the virus that is causing the current emergency, the Bundibugyo virus. 

Surge financing and strategic readiness through vaccine stockpiles go hand in hand to create a global mechanism for emergency vaccine deployment that strengthens the defences of every country. These tools are essential parts of an effective global health emergency architecture, and I would argue that the establishment of similar tools for therapeutics and diagnostics is long overdue. 

This would mean giving serious thought to whether new models of financing are needed to maintain stockpiles as a global public health insurance policy. And the question of whether the world needs a pandemic-sized surge-financing tool to complement the FRF will also loom large as we approach the UN General Assembly, during which pandemic preparedness will be a major focus. One thing is certain: finding answers to these questions now will make the world a safer place for us all when the next pandemic strikes.

Sania Nishtar is CEO of Gavi, the Vaccine Alliance

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