ARI SHAPIRO, HOST:
One year ago, the World Health Organization triggered its highest health alert over an outbreak of mpox. The disease, also known as monkeypox, was spreading in several countries in Africa. The WHO public health emergency was meant to mobilize international action. But one year later, critics say the response has faltered, and they warn that the world needs to do better. NPR's Gabrielle Emanuel is here to bring us up to speed. Hey, Gabrielle.
GABRIELLE EMANUEL, BYLINE: Hi there.
SHAPIRO: What made the WHO declare its highest level of emergency?
EMANUEL: Well, scientists were really worried. This virus had been circulating for a while, but there was a new strain of mpox that had just emerged. And while the disease symptoms were similar - you know, it gives you these very painful lesions - what concerned the experts was that this strain was spreading in ways it hadn't before and showing up in countries where it hadn't been seen before. Now, on top of all that, the heart of the outbreak was next to impossible to control because it was in the middle of a war zone in the Democratic Republic of Congo, and it was spreading among sex workers and their clients, many of whom have no access to health care.
SHAPIRO: Mpox has faded from the headlines since then, so where do things stand now?
EMANUEL: The virus is far from being controlled, and its geographic reach has actually expanded from 13 countries a year ago to 24 African countries today. And many of those countries, mpox is new. There have been maybe tens of thousands of cases, but here is the problem. We really don't know how big the outbreak is. And one of the reasons for this is that the U.S. used to be very involved in disease surveillance, but the Trump administration cut many of those programs. For example, in the Congo, the U.S. paid for transporting samples from suspected mpox cases to labs for testing. That stopped with the aid cuts. Here is Chris Beyrer of Johns Hopkins University.
CHRIS BEYRER: We have really gone off a kind of data cliff. We are flying blind. But since the response is so stalled, I'm not sure it's really flying. I think we're probably more like walking blind.
SHAPIRO: Walking blind doesn't sound good. There is a vaccine for mpox, right?
EMANUEL: Yes, there is a vaccine. And in the past year, around 900,000 people in Africa have actually been immunized against the virus, but that's far lower than the target. And the rollout of these vaccines has been chaotic, with lots of finger pointing between the WHO, the Congolese government and others. There were months of negotiations and bureaucratic hurdles. The bottom line is there has been a real shortage of vaccine.
Now, take the Biden administration's promise of 1 million mpox vaccine doses. Only 90,000 have made it to Africa. And hundreds of thousands of doses are stuck in warehouses elsewhere, and half of them have gotten too old to use. Here is Yap Boum of the Africa Centers for Disease Control and Prevention, the health agency of the African Union.
YAP BOUM: They can no longer be sent to the continent, which is a huge loss because one dose of vaccine is $100.
EMANUEL: I reached out to the Department of Health and Human Services about this and didn't hear back by our deadline.
SHAPIRO: So vaccines are going to waste and the outbreak is spreading. If this is how the world responds to dangerous diseases, how worried should we be?
EMANUEL: Well, I put that question to Boghuma Titanji of Emory University, and she is worried.
BOGHUMA TITANJI: If we have had the highest level of alert for 12 months and that hasn't really put a dent in the containment, how impactful is this lever?
EMANUEL: Now some push back and point to the resources that have arrived. But ultimately, there's agreement that it hasn't been enough, and the virus is getting more and more entrenched in the human population.
SHAPIRO: That's Gabrielle Emanuel. Thank you so much.
EMANUEL: Thank you. Transcript provided by NPR, Copyright NPR.
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