The COVID-19 Vaccines Global Access (COVAX) Facility was established early during the pandemic to support more equitable distribution of vaccines to low- and middle-income countries. Singapore was an early supporter of COVAX and co-chaired an informal Friends of COVAX Facility initiative with Switzerland to promote vaccine multilateralism.
However, such efforts were undermined by vaccine nationalism from high-income countries. Wealthy nations obtained a surplus of vaccine doses at prices well beyond what low- and middle-income countries could afford, and delayed access to vaccines incurred unnecessary excess suffering and deaths.
Nonetheless, COVAX’s novel global vaccine dose donation mechanism still exists, with the necessary expertise and experience at Gavi, the Vaccine Alliance. Gavi has committed to mobilising and delivering mpox vaccine doses to Africa.
That the world is experiencing the current mpox emergency can be viewed as a failure of not having “reached the last mile” during the earlier mpox emergency.
After all, even as the milder clade 2 mpox cases decreased worldwide (including in most African states) and the PHEIC was lifted in May 2023, a different situation was developing in the Democratic Republic of Congo. Mpox cases stayed high and rose sharply from September 2023, largely due to the clade 1b virus.
Issues of national sovereignty and global health security are complex, but there is an increasing urgency with each major outbreak for countries to work together in the interests of protecting health.
The International Health Regulations regarding global preparedness and public health emergency response have been strengthened by the World Health Assembly, the decision-making body of WHO, in June. But there is still a need for a robust global pandemic agreement which unfortunately has been deferred to 2025.
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