Gavi, the Vaccine Alliance based in Geneva, Switzerland, expressed concern over the escalating mpox crisis in Africa, particularly in DR Congo, where the outbreak has been severe, especially among children.

In a statement released on Thursday, August 15, Gavi welcomed measures by the African Centres for Disease Control and Prevention (Africa CDC) and the World Health Organization (WHO) to bolster a coordinated, region-led response to the crisis.

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Both organizations declared the situation a Public Health Emergency of Continental Security and a Public Health Emergency of International Concern, respectively.

Gavi stressed the critical need for international collaboration to address the growing threat. The Vaccine Alliance has been closely monitoring the mpox situation since 2022, and the ongoing crisis has influenced the design of its new health security mechanisms and its upcoming five-year strategy.

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Recognising the gaps exposed during the Covid-19 vaccine response, Gavi’s new strategies aim to enhance preparedness and response to health emergencies. During the assessment process for its next five-year Vaccine Investment Strategy (VIS) in 2023, mpox vaccines were considered a priority.

In early 2024, Gavi convened special sessions of the VIS Steering Committee to address the rapidly spreading outbreak in the DR Congo, which has resulted in high morbidity and mortality rates, particularly among children. In June, the Gavi Board approved several key measures to address the mpox crisis.

Global stockpile of mpox vaccines

Starting in 2026, Gavi will establish a global stockpile of mpox vaccines, similar to its existing stockpiles for other diseases like cholera, Ebola, meningitis, and yellow fever.

The creation of this stockpile will depend on the availability of WHO Emergency Use Listing or prequalification of a recommended vaccine and will require successful fundraising for Gavi’s next strategic period. A crucial goal of this initiative is to ensure that the stockpile is informed by a thorough assessment of long-term public health needs.

In the meantime, Gavi will support the outbreak response in DR Congo and surrounding countries. The organization aims to make critical investments in a learning agenda that will improve future vaccination efforts against mpox, including the design of a global stockpile.

As part of its ongoing emergency response, Gavi has declared the mpox situation a regional emergency, enabling the organisation to streamline processes and repurpose available funds to support vaccine responses.

This declaration also allows for the waiving of formal independent review processes for new vaccine introductions and campaigns, ensuring a faster and more flexible response.

In addition to immediate operational support, Gavi is leveraging new mechanisms to support the overall response to the mpox crisis. The Gavi Board approved the First Response Fund, part of the Day Zero Financing Facility, which aims to provide resources quickly in the event of a public health emergency.

This fund can be accessed following a WHO declaration of grade two or grade three emergency or a Public Health Emergency of International Concern and will support the direct procurement of mpox vaccines as well as country readiness efforts. Gavi has also accelerated its engagement with vaccine manufacturers, including Bavarian Nordic, to procure mpox vaccines for outbreak response.

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WHO has announced that two vaccines are currently under consideration for Emergency Use Listing, which would allow partners to act swiftly, ahead of the longer process required for WHO prequalification.

Building on its experience with the COVAX initiative during the Covid-19 pandemic, Gavi is coordinating with 33 donors and partners to supply donated doses of mpox vaccines to affected countries. In collaboration with the Congolese government, Africa CDC, WHO, UNICEF, and other stakeholders, Gavi helped design a three-phase vaccine response strategy, which considers the available supply of donated doses.

Gavi is investing in research to enhance understanding of mpox disease burden and epidemiology. This includes supporting surveillance and modelling studies on vaccine use and impact.

By expanding the available data, Gavi aims to ensure that the future global stockpile and vaccination efforts are effectively tailored to meet long-term public health needs. The organization is working with partners to finalise the design of this research agenda and plans to issue a Request for Proposals soon.