Fighting the mpox epidemic with prefabricated pharma factory systems in Africa

A fever, sore throat, muscle aches, and rashes or mucosal lesions on the skin. Recovery is usually spontaneous, unless an infected person has a weakened immune system, say, from untreated HIV. In severe cases, the disease can be fatal.

These symptoms and prognoses are characteristic of mpox, an outbreak of which is ravaging the Democratic Republic of Congo (DRC). Mpox has been a public health concern in the DRC for over a decade. Troublingly, year after year, the caseload has increased steadily. 2023 witnessed a significant rise in numbers, but 2024? Just over halfway through the year, the situation in 2024 has been worse. With 15,600+ cases and 537 deaths, 2024’s case numbers are higher than those for all of 2023.

To make matters worse, this year, at least 12 African countries have reported mpox outbreaks. In the DRC and its neighbouring East African countries Burundi, Kenya, Rwanda, and Uganda, the subtype clade 1b, claimed to be more deadly than other variants, is reportedly driving the surge. The infectious disease has the potential to spread further in Africa and beyond. Already, Sweden, Thailand and Taiwan have reported their first-ever cases of a clade 1b infection.

In light of this situation, on 14 August 2024, the World Health Organisation (WHO) declared that the massive spike in mpox cases in African countries constituted a public health emergency of international concern (PHEIC). This is the second time the international health agency has made such a declaration – in July 2022, when mpox spread to countries where the virus was not endemic, the WHO had declared a PHEIC.

In May 2023, as global cases started on a downward trajectory, the WHO declared the end of the emergency. Never mind that the increasing cases in Africa were largely ignored. Africa, where human cases of mpox have been detected as far back as 1970, “did not receive the support it urgently needed during this period”.

Taking things into their own hands: Africa’s growing autonomy in managing mpox

Having learned from the past, a day before the WHO’s declaration this year, on 13 August 2024, the Africa CDC had already declared the mpox outbreak a public health emergency of continental security (PHECS). With this official declaration, the first of its kind for the Africa CDC, it mobilized much-needed resources to tackle the outbreak. Resources that will unlock and enhance funding, surveillance, laboratory testing, risk communication efforts, and human resources capacity building.

Moreover, the Permanent Representatives Committee (PRC) of the African Union (AU) has also approved the use of $10.4 million from remaining Covid funds to help the Africa CDC fight this outbreak. These funds are intended to fortify five critical activities including enhancing mpox surveillance, improving prevention and control efforts, and strengthening data collection and analytics across African countries and the continent as a whole.

Additionally, the funds are intended to strengthen lab testing, genomic sequencing capacity, and access to and delivery of vaccines, diagnostics and other essential supplies to manage the caseload – PodTech™ is particularly keen to make a difference here with our quick, scalable and flexible podules™.

Making African health systems self-sufficient: An opportunity for authentic global solidarity

On 15 August, the BMJ published an opinion piece by a former Director General of the Nigeria CDC and the Chair of the Department of Global and Public Health at McGill University. These experts lamented the failure of global solidarity in response to outbreaks that affect low and middle-income countries.

Ebola only received global attention and substantial research funding when it began to affect wealthy nations. A similar scenario unfolded when mpox travelled beyond African borders in 2022. With the current outbreak, the world cannot afford to repeat the same mistakes.

Currently, the Africa CDC reports a need for 10 million doses of mpox vaccines, but only about 3% of that demand – about 280,000 doses – is available to inoculate the African population. The South African Health Department has attempted to source mpox vaccines from Western countries but to no avail.

As with Covid-19, Ebola, HIV/AIDS, and now mpox, a pattern is evident – as wealthy countries hoard vaccines and impede patent waivers, Africa is always last in line to access lifesaving tools.

There is only one solution to prevent further infections within Africa and beyond. In the words of the WHO Director General, “a coordinated international response is needed to stop these outbreaks and save lives.”

The way forward: Equipping Africa with the tools it needs

The World Health Assembly’s failure to achieve a consensus on the pandemic accord has made it clear that Africa needs to develop its own tools to manage public health. The authors of the BMJ article posit two approaches for Africa to achieve this – with a little support from the international community, of course.

To deal with the immediate crisis at hand, the Africa CDC needs not only sufficient funding but also access to the vaccine doses, drugs and diagnostics that can help stem the spread of the outbreak. International support combined with domestic funding can help extend surveillance and other public health measures.

For the long term, Africa already has a plan in place i.e. the New Public Health Order for Africa. Achieving this vision requires Africa to double down on investments in stronger public health institutions, workforce, partnerships, and a larger manufacturing ecosystem to make its own medicines, vaccines and diagnostics. In other words, Africa needs to invest in its infrastructure – physical, technological and beyond – if it wants to make sustained progress in fighting infectious disease outbreaks.

With no time to lose in achieving these short- and long-term objectives, we cannot stress enough the need for modular construction. Prefabricated systems such as the podules™ we engineer at PodTech™ offer the best solution to Africa’s capability-building problem.

Traditional brick-and-cement construction? That can take years to become operational. Modular components that are manufactured off-site and only assembled on-site? Those can be up and running in half as much time.

An epidemic that is suddenly raging across a country? Scalable pod designs ensure that authorities and entrepreneurs can add on production capacity as needed.

A new outbreak that calls for the development and manufacture of a new range of medicines and vaccines? There are fully equipped podules™ for that.

Be it labs, patient recovery, diagnostic manufacturing or R&D, PodTech™’s podules™ can be tailored to meet diverse biopharma and health needs. These podules™ are a critical component in the fight for genuine health equity and greater health access in Africa. To fight the ongoing pandemic, we can think of no better solution than to invest in modular, prefabricated factory systems today.