STEVE INSKEEP, HOST:
The first doses of an mpox vaccine have arrived in Africa. That's where a surge in cases led the World Health Organization to declare an international emergency a couple of weeks ago. Health authorities say there are not nearly enough vaccine doses. They are millions short. And the hardest-hit country, the Democratic Republic of Congo, has no doses at all. NPR global health correspondent Gabrielle Emanuel is covering this story. Good morning.
GABRIELLE EMANUEL, BYLINE: Hi.
INSKEEP: Why is it so hard to get the vaccines to where they're needed?
EMANUEL: It feels like it should be straightforward. One country needs vaccines, another is ready to give them, but turns out it is not that simple. It is complicated logistically, scientifically, financially. We're talking about an expensive vaccine. But right now the biggest hurdle is bureaucratic. I'm talking regulatory and administrative issues. For example, the U.S. government has been ready to donate doses for two years, but it hasn't happened. One health official with direct knowledge of the situation who wasn't authorized to speak publicly called the international administrative process a nightmare.
I also spoke with Rick Bright. He was a top U.S. government scientist and is an expert on pandemic response. He says there's plenty of frustration and finger-pointing, with folks in the U.S. frustrated with the WHO. Meanwhile, the WHO says they're waiting for the Democratic Republic of the Congo, and the DRC says - you know, so on and so on.
RICK BRIGHT: It really is this shell game. And in the meantime, people are getting infected. The virus is mutating and spreading more widely, and people are dying.
EMANUEL: And complicating matters is the fact that the WHO is still working on green-lighting the usage of mpox vaccines.
INSKEEP: WHO - World Health Organization - important global health organization, and they know that this disease causes painful skin problems. It can be deadly. Why would they not authorize the vaccine for use elsewhere?
EMANUEL: So the process is underway. It is already authorized in some places, like here in the U.S - it's in use right now. But the WHO has said that there are a lot of gaps in our knowledge about the vaccines. For starters, the majority of cases and deaths in the DRC are in children. But the vaccine the U.S. wants to donate and many of the studies were not done in children. They were done in U.S., Europe in gay and bisexual men.
We also, in this outbreak, have a different, more dangerous strain of mpox circulating in the DRC and other countries, and we don't have studies on that. Still, many are saying, you know, this is an emergency. There are more than 20,000 cases of mpox this year in Africa, and vaccines are one of our best shots, especially given that there are no treatments specifically designed for mpox.
INSKEEP: One of our best shots - nice pun. Well done.
EMANUEL: (Laughter).
INSKEEP: Should we worry about this spreading to the United States?
EMANUEL: Yeah, so health officials here in the U.S. have issued an alert for clinicians to be on the lookout, aware of symptoms, aware of what's going on. The U.S. is also watching at airports around the U.S., testing the wastewater - basically the toilet water that comes out of airplanes - to see if the virus is in there. And there's another reason we should be thinking about all of this - that the vaccines that have been pledged and are destined for Africa are not nearly enough doses. The Africa Centres for Disease Control and Prevention say they need 10 million doses. Right now we're talking hundreds of thousands of doses promised.
INSKEEP: Wow. This brings to mind COVID, where there's this demand for vaccines but only the wealthier countries seem to get them.
EMANUEL: Yes, the analogy with COVID has come up a lot. Here is Jean Kaseya, director-general of Africa CDC.
JEAN KASEYA: We faced COVID. We didn't have vaccines, were abandoned. Today, we are in a similar situation.
EMANUEL: So Africa CDC and others are trying to change this, trying to develop local vaccine manufacturing. But that is very much a long-term strategy.
INSKEEP: Now, NPR's Gabrielle Emanuel, thanks so much.
EMANUEL: Thank you.
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