Mpox: nothing learned from COVID-19

A new strain of Mpox is tearing through Central Africa. Since the start of the year, 13 African countries have reported more than 22,800 Mpox cases and 622 deaths, which represents a 160 percent increase compared with the same period in 2023. This is likely only a fraction of the real number. What is clear is that, four years on, nothing has been learned from COVID-19.

The recent explosion of the disease threatens a worldwide outbreak. In August, the WHO declared Mpox a “public health emergency of international concern” (PHEIC). Shortly afterwards cases were detected in Sweden, India, Pakistan, the Philippines and Thailand.

With the experience of the COVID-19 pandemic fresh in mind – as well as the last global outbreak of Mpox in 2022 – one might assume that the governments of the world would join together to tackle this crisis before it gets out of control.

On the contrary. In spite of the frantic calls of the global health community, the world is stumbling blindly and inevitably into a new health crisis, blighted by exactly the same things that undermined a rational, global response to COVID-19: the private ownership of the pharmaceutical industry, and antagonistic nation states.

The disease

Mpox (formerly known as Monkeypox) is a virus from the same family as Smallpox, though it is much less fatal. Although not as easily transmissible as COVID-19, being largely transmitted by bodily contact, it is three to four times more deadly. Among its symptoms are fever, aching muscles, and, most recognisably, an outbreak of blister-like rashes all over the body.

The disease is endemic in forested areas of West and Central Africa, and 90 percent of the current cases stem from the Democratic Republic of Congo. Congo is largely covered by a gigantic rainforest and, as a result, it is here that diseases tend to leap from animal to human populations. Spillovers of this type are estimated to have increased due to the extinction of large game, which has forced people to hunt and eat small mammals, the typical couriers of many of these diseases.

As capitalism destroys environments, drives extinctions, forces unusual migrations of animals, and pushes human beings to the margins, new epidemics and pandemics are becoming increasingly common: from HIV to Ebola, Nipah, Zika, SARS, COVID-19 and Mpox, not to mention worse outbreaks of familiar killers, including malaria and cholera.

As one of the most impoverished and underdeveloped countries in the world, the DRC is a perfect breeding ground for disease / Image: MONUSCO/Sylvain Liechti, Wikimedia commons

Mpox is transmitted via close contact, and it is much more dangerous among those with compromised immune systems (e.g. those with HIV) and children. In fact, children younger than 15 account for 66 percent of cases and 82 percent of deaths in the recent outbreak. 

Thus, as one of the most impoverished and underdeveloped countries in the world, the DRC is a perfect breeding ground for disease. Only 25 percent of the population have access to clean water (even though the country possesses half of Africa's water reserves) and 40 percent of children are malnourished and their immune systems are thus very weak. At the same time, poor, dependent, and exploited Congo lacks the infrastructure to properly track and treat diseases: with a modern healthcare system, the death rate of the current Mpox epidemic could be halved.

As a result, on top of Mpox, DRC has suffered from the world’s second highest number of malaria cases and deaths, the world's worst measles epidemic, and was last year reported to be experiencing outbreaks of yellow fever, cholera, and Bubonic plague. 

The current crisis in the Congo, which is set to spiral into full blown war, has massively exacerbated these problems. So far, the war has caused the internal displacement of 7.2 million, and the exodus of 1.1 million refugees. Attempting to flee the nightmare caused by imperialism, these poor souls have become vectors of Mpox, spreading it over the country and across the continent. The barbarism and war that capitalism is spreading across the continent is bringing these horrors in its train.

Since its discovery in 1951, Mpox was left to fester in the Congo and surrounding region, until, in 2022, cases exploded internationally. In what was then the worst outbreak of the virus in its history, it spread to 111 countries, infecting 87,000 and causing 140 deaths. At that time, the WHO designated Mpox a PHEIC. This was dropped in May 2023, when, panicked into action, America and Europe sharply reduced cases with a costly vaccination programme. The virus was not eradicated, however, and remained an emergency in Congo. 

As a result, the current outbreak – which began in 2023 – is set to be much worse. The new outbreak, caused by the clade Ib, has an estimated mortality rate of between 1 and 10 percent, compared to less than 1 percent in clade 2, responsible for the 2023 outbreak. Already, the death count of the new strain has surpassed the 2022 outbreak by at least fourfold.

The cure

If you are a shareholder of Bavarian Nordic, this is all fantastic news, for Bavarian Nordic is lucky enough to share a duopoly of the Mpox vaccine. In fact, when the classification of Mpox as a PHEIC was announced, shares in the company jumped 46 percent!

These ‘enterprising’ capitalists charge between $100 and $200 for shots that cost $4 or less to produce. Some have criticised this as obvious profiteering but, in the words of the CEO – who earns about $2 million a year: “Of course we’re also a company, we have to make money.”

Graph showing share prices of Bavarian Nordic / Image: own work

As he later said: “At the end of the day, if we financially damage Bavarian Nordic in any way, that doesn’t benefit the world’s society because then there’s no vaccine available for anyone.”

He also noted that, “There hasn’t been a lot of demand from sub-Saharan Africa.” This is probably because it would cost an estimated $4 billion to buy and distribute the 10 million vaccines the continent desperately needs. This is small change to the advanced capitalist countries, but a fortune to war-torn central Africa. As the vice president of investor relations at Bavarian Nordic candidly put it, “It’s very unlikely that any African country will ever be responsible for buying vaccines”.

Instead, the afflicted, impoverished nations are reduced to begging for the cure from the rich. So far, 265,000 vaccines have been donated to the DRC by the EU and the US, which translates to 2.65 percent of what is estimated to be necessary.

This is absurd. Bavarian Nordic itself has a stockpile of half a million doses. Over the 2022 outbreak, it supplied over 15 million doses, most of which are sitting unused in stockpiles. The holders of these stores have been coy about the real totals, but the US alone is reported to be sitting on 7 million vials.

The Netherlands has outrageously refused to send any of its 100,000 vaccines, even though some of them are soon to expire. But this is not an aberration. It only displays the narrow, cynical, and selfish interests that govern all capitalist nations. In the same way, the US preferred to let 20 million Mpox vaccines expire instead of distributing them to where they were needed. This greedy stupidity left them totally undefended before the 2022 outbreak.

In the midst of this madness, the WHO has attempted to call the world to order and organise the necessary coordinated world response. But it is a toothless body. It can make all sorts of declarations, but it is totally undermined by the cutthroat competition of the countries that fund it.

It has, for example, only been able to give one tenth of what is required to set up an Mpox surveillance programme. Instead, it has been forced to go cap in hand to its donors to ask for the extra $15 million.

Capitalism must be eradicated

Under capitalism, it's every man for himself, and every national gang of capitalists for itself. Rather than rationally distribute medical supplies to where they are needed in the world, the countries with the means to do so hoard them. From their perspective, in a world breaking apart into hostile camps, with all the powers sharpening their knives for imperialist butchery, vaccinating far away Africa is at the bottom of the agenda.

Over the last four years, it is estimated that between 19 and 36 million people died as a result of the COVID-19 pandemic, most of those because of an international lack of coordination and unpreparedness. But nothing has been learned. In spite of all of their treaties, handshakes, and sober declarations that next time they’ll come together for the greater good, these parasites are driven by the same interests that led to a complete worldwide catastrophe in 2020. 

 The COVID-19 pandemic and the 2022-23 outbreak of Mpox have given the world fair warning. And yet, we're tobogganing with our eyes closed towards another public health catastrophe / Image: World bank photo collection, Flickr

Viruses know no borders. Only when a disaster inevitably flares up, do they scramble to do something.

Mpox is not Covid, however. We have known about Mpox since the 1950s. We have the means to track it and we have the cure in abundance. The COVID-19 pandemic and the 2022-23 outbreak of Mpox have given the world fair warning. And yet, we're tobogganing with our eyes closed towards another public health catastrophe. There was no attempt to distribute PPE to affected areas, to carry out public educational programmes, or mass vaccination.

Mpox is unlikely to assume the same proportions as COVID-19 in the rich countries. But thousands of people will die. Their misfortune is that they live in the poorest countries on Earth, and therefore the wealthy capitalist nations do not give a damn.

Moreover, Mpox is one of many diseases that, left alone, could develop into devastating pandemics. Dengue fever, Chikungunya, Lassa fever; these are just a few of the viruses currently circulating amongst the poor of the world. Yet the holders of the wealth turn a blind eye, and the holders of the vaccine patents make millions.

It is not merely viruses and bacteria that are at the root of these increasingly common healthcare emergencies, but capitalism itself. So long as the planet is divided into nations engaged in a mutually exclusive struggle for resources, and so long as production is directed in the interests of a handful of billionaires, these nightmares will persist.

Communism is the solution. If the private owners of medical infrastructure were expropriated, a rationally planned, fully funded, international public health system could work systematically to eliminate such diseases. Until then, capitalism will continue to unleash famine, war and pestilence on the mass of humanity.