The making of monkeypox, Part One

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The making of monkeypox, Part One

By

Paula Jardine

August 21, 2024

LAST Wednesday, Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization (WHO) declared the second monkeypox public health emergency of international concern (PHEIC) due to cases of once-rare monkeypox (now rebranded as mpox) being reported in ten African countries.

‘In addition to other outbreaks of other classes of mpox in other parts of Africa, it’s clear that a coordinated international response is essential to stop these outbreaks and save lives,’ he said, while appealing for more money and vaccines from donors.

This announcement followed hard on the heels of last week’s WHO invitation to mpox vaccine manufacturers to submit dossiers for emergency use listings (EULs).

EULs enable UNICEF and GAVI to buy unlicensed medicines for distribution to low-income countries. Monkeypox is indistinguishable from smallpox without laboratory testing, thus vaccines against the ‘eradicated’ smallpox with their otherwise limited commercial markets are being repurposed and deployed.

The combination of EUL and PHEIC also means the manufacturers can expect to use the people of low-income countries such as Democratic Republic of Congo (DRC), which is once again at the centre of the outbreak, as guinea pigs, liability free. The question that must be asked is why nearly all PHEICS have arisen from this impoverished but, on account of its unparalleled wealth of natural resources, strategically important country. Monkeypox, and ebola before it, were fleetingly rare from their discovery five decades ago until the past decade. More importantly, questions need to be asked about what possible contribution the vaccines programmes thrust successively upon DRC and other African countries during the last 15 years have played.

Monkeypox, which is clinically indistinguishable from smallpox, was identified in 1958 following a non-fatal outbreak in cynomolgus (crab-eating) macaque monkeys at the State Serum Institute of Copenhagen. These monkeys, which are native to South East Asia, had been imported by SSI from Singapore for their polio vaccine programme. Although monkeypox has an incubation period of 3-17 days, the monkeys became ill considerably later, 51-60 days after arriving in Denmark. The Institute concluded the sick monkeys must have had latent infections when they arrived as they found some virus in the kidneys of healthy monkeys at autopsy, a potentially serious issue as monkey kidneys are used to manufacture polio vaccine.

Over the next decade, occasional outbreaks of monkeypox occurred in Asian monkeys in numerous polio vaccine laboratories around the world but no humans were ever infected. This led Donald Henderson, the Chief Medical Officer of the Smallpox Eradication Program (SEP), to conclude that ‘man may be comparatively insusceptible to this virus’.

Even so, in the 1970s the SEP run by Henderson began surveillance for monkeypox in Africa, where crab-eating monkeys are not found, but polio vaccines were. In 1970, two years after the last reported smallpox case in Zaire (later the DRC), the first human monkeypox case was identified in a nine-month old infant. He died of measles two months later. Over that decade, only 47 human cases of monkeypox were reported in Africa, 39 of them in children under the age of ten. Three adults and a child had visible smallpox vaccination scars, but blood tests on 36 of the patients showed all but one already had antibodies to orthopox viruses (the class of viruses which includes smallpox and monkeypox) due to previous exposure. Thirty-eight of the cases occurred in Zaire, and seven under-sevens died, an unremarkable number over the course of a decade for a country with a 20 per cent all-cause infant mortality rate. It was labelled a zoonosis (an infection transmitted from animals to humans) and bushmeat consumption was blamed, as usual. It’s probably safe to assume, and I have found no evidence to the contrary, that no one considered whether polio vaccines played a contributory role.

The August 2024 PHEIC is the second monkeypox PHEIC. Monkeypox, or ‘mpox’ as the WHO now insists on calling it, was something of a damp squib until 2022 when case reports rose to levels 23 times higher than all previous incidences. Public Health authorities claim it is endemic to the tropical rain forests of Central and West Africa yet, oddly, these countries accounted for only 1 per cent of cases.

The WHO European Region announced in May 2022 there was an atypical outbreak of monkeypox. The UK was the first country to report cases on May 7, 2022. Following this, the WHO Emergency Committee was asked in June 2022 to consider whether monkeypox was an emergency, but resolved, by consensus, that no PHEIC existed. Undeterred, Director General Tedros Adhanom Ghebreyesus asked again, and although the committee failed to reach a consensus, he declared the first monkeypox PHEIC on July 23, 2022 with the WHO now claiming monkeypox, which previously mostly presented in under-tens, is a sexually transmitted infection.

‘Although I am declaring a public health emergency of international concern, for the moment this is an outbreak that is concentrated among men who have sex with men, especially those with multiple sexual partners,’ said Dr Tedros. ‘That means that this is an outbreak that can be stopped with the right strategies in the right groups.’

One reason Tedros gave for the 2022 PHEIC, which was likely the overriding consideration, was ‘to accelerate research into the use of vaccines, therapeutics and other tools’. In fact the day before Tedros announced the PHEIC, the European Medicines Agency (EMA) said that Imvanex, a live modified vaccinia Ankara (MVA) (smallpox) vaccine manufactured by Bavarian Nordic, was considered a potential vaccine against monkeypox, due to the similarity between the two viruses. The PHEIC doubtlessly unlocks Bavarian Nordic’s standing contract with the US Biomedical Advanced Research and Development Authority (BARDA) for this vaccine, that expires in 2026 and is worth up to $1.03billion. The EMA which, in 2013, issued a marketing authorisation for Imvanex to prevent smallpox, said its Committee for Medicinal Products for Human Use (CHMP – yes, it’s pronounced Chimp) was inferring from animal testing that it ‘could be effective in preventing monkeypox in humans’, thus it was extending Bavarian Nordic’s marketing authorisation, enabling the company to ‘confirm its effectiveness’ by collecting data from an observational study during the ongoing European outbreak of monkeypox.

In 2019, following a CDC-funded trial of MVA-BN conducted in the DRC to see if it worked against monkeypox which was claimed to be endemic to the region, the US Food and Drug Administration (FDA) authorised it for such use under the brand name JYNNEOS. Conveniently, a US PREP Act liability waiver covering JYNNEOS for use against monkeypox was already in place following a 2016 declaration extending a 2008 smallpox countermeasure liability coverage to other orthopoxes. In August 2022 the FDA issued an emergency use authorisation (EUA) for JYNNEOS to be used as a monkeypox vaccine. The UK’s Medicines and Health Products Regulation Authority (MHRA) then decided to permit the importation of JYNNEOS, saying using the European licensed version Imvanex against monkeypox would constitute ‘off-label use’. This, it seems, was a hedge against potential compensation claims arising from its use.

Helping Bavarian Nordic make money on its smallpox vaccine is one thing, but the 2022 PHEIC also propelled mRNA-mpox vaccines into development.

On May 23 2023 Moderna announced they were beginning pre-clinical work on an mRNA vaccine. They are sure to be amongst the EUL applicants. By August 15 2023, as part of their ten-year strategic collaboration with the UK government, Moderna and the NHS began recruiting 350 healthy volunteers who hadn’t previously been vaccinated for mpox or smallpox to participate in the mPower phase 1 & 2 clinical trial of Moderna’s new mpox vaccine mRNA-1769.

The Coalition for Epidemic Preparedness Innovations (CEPI), the self-appointed ‘Just in case, Just in time’ vaccine organisation set up by Jeremy Farrar and Bill Gates, which was active in endorsing the Covid lockdowns so necessary for vaccine development in 2020, were also on the case. In September 2023 CEPI kicked in $90million of funding to BioNTech, Moderna’s rival, to get it working on a new vaccine. This is how Professor Ugur Sahin, CEO and co-founder of BioNTech, justified it: ‘Mpox can cause severe complications, particularly in children and pregnant women as well as in immunocompromised individuals. The global outbreak, which was declared a public health emergency of international concern, underlines the need for a highly effective, well-tolerated, and accessible mpox vaccine . . . We initiated our BNT166 program in May 2022 to help address this need.’

It would seem that the real reason for the second monkeypox PHEIC is to facilitate large scale phase 3 testing of these mRNA vaccines. After all, ‘it’s an emergency’ – there have been nearly 14,000 cases. But what might be driving the increasing numbers of people suffering from the once rarely seen monkeypox?

TCW

Me: Well, it is in the Congo, so unless you are going there to fuck young black men, I doubt you would get it from other Male Gay's, would you?