It has been a year since the first outbreak of a new more deadly variant of the mpox virus was first reported in central Africa. Since the start of the year, more than 20,000 cases and well over 500 deaths, most of them children, have been officially reported, but the actual numbers are likely higher. The epicentre of the outbreak has been eastern Democratic Republic of the Congo (DRC), which has suffered the overwhelming majority of deaths.
In mid-August, the World Health Organisation declared the mpox outbreak a “public health emergency of international concern”. Countries around the world looked on nervously, but few seemed to recognise that this was all avoidable, if only we would stop treating a large part of humanity as disposable.
Two years ago, we had already had a wake-up call when a less deadly variant of mpox spread to Europe and the United States. Vaccination campaigns were rolled out fairly rapidly. Yet, no lessons were learned about the dangers of ignoring diseases in Central Africa.
After the moment of panic passed, at least in Washington, London and Brussels, Western governments built massive vaccine stockpiles, and kept them to themselves. Those parts of Africa where mpox has been endemic for two decades were forgotten, left without vaccines even while millions were produced.
It is only in the last week that Africa received its first vaccines. On August 27, USAID delivered 10,000 doses to Nigeria. On September 5, the DRC finally received 100,000 doses. There is no question that vaccinations could significantly contain the spread of mpox but these donations came late.
There are plenty of players to share the blame for this state of affairs, but the heart of the problem, as we saw in the obscene inequality which characterised the COVID-19 global vaccine rollout, is that some lives simply don’t seem to matter. Or rather, they matter significantly less than the accumulation of wealth by the few. They matter less than profit.
Two companies produce the main mpox vaccines, a Japanese company called KM Biologics and a Danish corporation called Bavarian Nordic. Bavarian’s share price has spiked in recent weeks, thanks to the mpox outbreak. The vaccine was produced thanks to massive injections of public cash, but the price tag charged by Bavarian Nordic – $200 to inoculate each individual – is out of reach of many African countries. Most of the doses it produces go to the US and other rich countries.
US advocacy group Public Citizen says it fears “that Bavarian Nordic may be exploiting the latest global health crisis, putting profits over people”. If the company would share its technology with factories in low and middle-income countries, the group says, the price could be slashed. Similar vaccines are produced for $4 a dose or less. What’s more, Africa would then be in a better position to meet its own needs in the future.
But the company won’t do that. It claims that’s not how its business model works. Instead, it is encouraging rich governments to buy full-priced vaccines and then donate them.
But this hasn’t happened either. With only a few exceptions like Spain, which pledged to donate 500,000 doses from its own stockpile, rich countries’ donations have been a fraction of what’s needed. Nor will these donations help prepare the DRC in future crises. Campaigners are clear – both Bavarian Nordic and KM Biologics must share their research with other manufacturers to increase supply and bring prices down.
It is claimed that accessing vaccines is only one part of the problem, that the regulation and administration of vaccines is a massive challenge. That is true enough, but it hardly justifies hoarding technology and keeping prices high.
Even with mpox spreading in the DRC, parts of the pharmaceutical industry and their rich country backers have opposed a new post-COVID framework which would help. The Pandemic Treaty is supposed to allow the whole world to better prepare for and deal with pandemics, recognising that our safety is interdependent.
But the United Kingdom, along with other rich countries, has stalled the process, afraid of an international agreement which puts saving lives ahead of Big Pharma company profits. The intellectual property of these corporations trumps lives in the Global South.
In any case, the wider background to the failure to prevent Africa’s latest health emergency goes back much further. But again, it is deeply embedded in the way the global economy works, an economy which places a far lower value on human life than it does on the unassailable right to profit. We come to accept this is how things have to be, thanks to a heavy dose of racism injected into the public discourse to “explain” why the DRC is so helpless, its people so disposable.
By some measures, the DRC should be the wealthiest country on earth, rich in the metals and minerals we use in modern life. But in income terms, it is actually close to being the poorest.
The reason is that the country has been bled of its wealth, over hundreds of years, through brutal colonialism and slavery. Its democratic politicians have been assassinated and dictators installed and funded; vast illegitimate debts have been imposed on the people; and massive revenue from the natural resources taken from the country.
DRC is not poor in spite of its natural wealth but because of it. The lives of its people simply have no value to the extraction machine, and are disposable when they get in the way of doing business.
Today, mpox is spreading across resource-rich eastern DRC, affecting those unfortunate enough to live on top of resources which can make others so wealthy. Eastern DRC is being destabilised by various militias, some backed by its neighbours, in order to continue the plunder of resources. Western countries do little to prevent this destabilisation.
It doesn’t have to be like this. And right now, we have a limited period when, fearing the spread of mpox, people are able to grasp how our health is interconnected, and how the people of Central Africa are not irrelevant to us.
Valuing their lives means we must immediately prioritise vaccinations over corporate profit and selfish stockpiling. We need massive donations, together with assistance to help administer vaccines and treat patients. And we need to transfer the vaccine know-how to local manufacturers so they can start producing their own, building sovereignty over their healthcare which will allow them to deal with future emergencies.
But this is only the start. Unjust access to mpox vaccines is only a microcosm of deeply unjust global relations which need to be redressed, most urgently by bringing to an end the destabilisation of the DRC, cracking down on tax dodging and ending the looting of DRC resources.
This is an enormous task. But the alternative – to keep ignoring the needs and lives of a large section of humanity because it gets in the way of profit – is not only wrong, it will subject all of us to new, dangerous epidemics. None of us can be secure in such a world.
Aljazeera
