In coordination with Member States, the World Health Organization (WHO) and partners have established an access and allocation mechanism for mpox medical countermeasures including vaccines, treatments and diagnostic tests. The Access and Allocation Mechanism (AAM) will increase access to these tools for people at highest risk and ensure that the limited supplies are used effectively and equitably.   

This is part of the response to the public health emergency of international concern declared by WHO Director-General Dr Tedros Adhanom Ghebreyesus on 14 August 2024, following an upsurge of mpox in the Democratic Republic of the Congo and neighbouring countries. Fifteen countries in Africa have reported mpox this year. Recommendations issued on the advice of the International Health Regulations Emergency Committee asked States Parties to ensure "equitable access to safe, effective and quality-assured countermeasures for mpox.”  

“Alongside other public health interventions, vaccines, therapeutics and diagnostics are powerful tools for bringing the mpox outbreaks in Africa under control,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus. “The COVID-19 pandemic illustrated the need for international coordination to promote equitable access to these tools so they can be used most effectively where they are most needed. We urge countries with supplies of vaccines and other products to come forward with donations, to prevent infections, stop transmission and save lives.” 

The AAM was established as a part of the interim Medical Countermeasures Network (i-MCM-Net). The i-MCM-Net brings together partners from around the world, including UN and other international agencies, health organizations, civil society organizations, industry and private sector to build an effective ecosystem for the development, manufacturing, allocation and delivery of medical countermeasures. The network was endorsed by WHO Member States as a mechanism to operate in the interim, as negotiations continue towards a pandemic agreement. 

Along with WHO, the AAM for mpox includes members of the i-MCM-Net: the Africa Centres for Disease Control and Prevention, the Coalition for Epidemic Preparedness Innovations, the EU’s Health Emergency Preparedness and Response Authority, FIND, Gavi, the PAHO Revolving Fund, UNICEF, Unitaid and others. 

Over 3.6 million doses of vaccines have been pledged for the mpox response.  This includes 620 000 doses of the MVA-BN vaccine pledged to affected countries by the European Commission, Austria, Belgium, Croatia, Cyprus, France, Germany, Luxembourg, Malta, Poland, Spain, and the United States of America, as well as vaccine manufacturer Bavarian Nordic. Japan has pledged 3 million doses of the LC16 vaccine, the largest number of doses pledged so far.   

The recent surge in mpox cases, coupled with the limited availability of vaccines and other medical countermeasures, underscores the need for a collaborative and transparent process to distribute these critical resources fairly. The AAM is working to allocate the currently scarce supplies of vaccines and diagnostics for those at the highest risk of infection, including for vaccinating contacts of confirmed cases, and providing access to point of care diagnostics to countries with ongoing mpox outbreaks so that people who might be suspected cases can systematically be tested and cared for.  

The AAM will operate based on these guiding principles:  

• Preventing illness and death: Prioritize vaccination and other tools to interrupt transmission for those at greatest risk to prevent illness and death.  
• Mitigating inequity: Ensure equitable access to medical countermeasures for all people at risk, irrespective of socio-economic or demographic background.  
• Ensuring transparency and flexibility: Establish and maintain clear and open communication about allocation decisions and be ready to adapt strategies as new data emerge or situations change.

“WHO and partners are supporting the government of the Democratic Republic of the Congo and other countries to implement an integrated approach to case detection, contact tracing, targeted vaccination, clinical and home care, infection prevention and control, community engagement and mobilization, and specialized logistical support,” said Dr Mike Ryan, Executive Director of WHO’s Health Emergencies Programme. “The AAM will provide a reliable pipeline of vaccines and other tools in order to ensure the success on the ground in interrupting transmission and reducing suffering.”