Summary

Ambassador John N. Nkengasong, the U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy, discusses U.S. support for the global response to the clade I mpox outbreak. The U.S. government has been closely monitoring the spread of clade I mpox in Democratic Republic of the Congo (DRC) and the growing number of cases in the region, and we have been working closely with the affected country governments, as well as regional and global health partners, to reduce the impact of this outbreak. 

MODERATOR:  Good afternoon to everyone from the U.S. Department of State’s Africa Regional Media Hub.  I welcome our participants logging in from across the continent and thank all of you for joining us.  Today, we are very pleased to be joined by the U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy, Ambassador John Nkengasong, who will discuss the U.S. support for the global response to the clade I mpox outbreak.  

The U.S. Government has been closely monitoring the spread of clade I mpox in the Democratic Republic of the Congo and the growing number of cases in the region and has been working closely with the affected country governments, as well as regional and global health partners, to reduce the impact of this outbreak. 

We will begin today’s briefing with opening remarks from Ambassador Nkengasong, then we will turn to your questions.  We will try to get to as many of them as we can during the briefing.  Please note that today’s briefing offers simultaneous live French interpretation. 

With that, I will turn it over to Ambassador Nkengasong for opening remarks.  

AMBASSADOR NKENGASONG:  Thank you and good afternoon, all, and good morning for those who are on the same time zone as we are in Washington, D.C.  Truly an honor to have the opportunity to discuss the mpox situation with all of you.   

A little more than one month since the Africa CDC and the World Health Organization declared public health emergencies related to the upsurge in clade I mpox cases, I’m pleased to share some details of the whole-of-government efforts by the United States to support the global response to this outbreak.  

The longstanding partnership the United States has built with mpox-affected countries in the region over the last 20 years to fight infectious diseases, including HIV, TB, Ebola, malaria, and others, is very crucial in the response to this outbreak.   

So a couple of very specific things that the United States has done or continues to do.  Over the last year, in 2023, the United States allocated more than 2.65 billion – 2.65 billion – in bilateral health funding to countries in Central and East Africa, more than any other donor.  We have been working very closely this past year with the DRC and other affected country governments, as well as regional and global health partners, to monitor and respond to the great number of the clade I mpox cases.   

Secondly, in March of this year, USAID and CDC together have already provided over 20 million to support mpox response efforts for Central and East African countries.  And on August 20th, USAID announced up to an additional 35 million in emergency reserve funds to support the response in the region, which is currently pending notification in the U.S. Congress.  

Last week, the United States delivered 50,000 doses of the mpox vaccine to DRC, which we have seen on Friday that this vaccine has been prequalified by WHO, which is very good news.  And we’re also providing financial support for the rollout of the vaccine doses.  Along with donations from the European Union and the manufacturers, more than 250,000 doses have been delivered to DRC in the last two weeks alone. 

The United States support also includes testing, genetic sequencing, laboratory training, health workforce, surveillance, and infection control and prevention in people and animals.  Infection control and prevention, risk communication, and community engagement and research are all critical tools that will be required to blunt the spread of this virus.  In short, we need an integrated approach that includes vaccines, but every other measure that I’ve indicated – notably surveillance, laboratory, infection control, and community engagement.   

This outbreak underscores yet again that an infectious disease threat anywhere in the world is a threat everywhere in the world.  The United States State Department has regularly been in touch with the partner countries and those in the region through WHO, the Africa CDC, and the Foreign Ministry Channel on Global Health Security that is chaired by Secretary Blinken to make sure that we coordinate our efforts and enhance collaboration.  We will be addressing more details on this outbreak during the Foreign Ministry Channel which will be hosted on the sidelines of the UN General Assembly.  

Thank you.   

MODERATOR:  Thank you, Ambassador.  We will now begin the question-and-answer portion of today’s briefing.  We ask that you limit yourself to one question only related to the topic of today’s briefing, which is the U.S. support to the global response to the clade I mpox outbreak. 

Ambassador, our first question goes to Franco Lelano from Guinea-Conakry, and his question is:  “What’s the origin of this virus, where does it come from?” 

AMBASSADOR NKENGASONG:  Thank you.  Thank you so much for that question – very important question.  I think mpox was first discovered in 1958, and the first human case of mpox was recorded in 1970 in what is now called the DRC, the Democratic Republic of Congo.   

The source of the disease remains unknown, but scientists believe that it’s from animals, specifically from rodents, and non-human primates may harbor this virus.  I think we continue to learn more as research conducted by our own agencies, the United States Centers for Disease Control and others, are actively working on this.  But we all know that at least 60 to 70 percent of new infections originate from zoonosis, which is cross-species transmission from animals to humans.  So it is very, very likely that this is another case of a zoonotic infection.  

MODERATOR:  Thank you, Ambassador.  Our second question comes from Mr. Bill from B One in the DRC, and he asks:  “How much does the U.S. Government plan on donating to combat mpox in the DRC?  Following the recent donation of 50,000 vaccines to the DRC, what actions does the U.S. Government plan to take until the mpox outbreak is fully under control?”   

AMBASSADOR NKENGASONG:  So as I said earlier, the United States Government plans to continue to deepen its partnership and collaboration in support of DRC and the neighboring countries, and the overall global response, just to put it that way.  We are very committed to global health security.  You know that – you probably are aware that we have a partnership that has been developed to expand global health security before this pandemic – or not pandemic but outbreak occurred in more than 50 countries.  So this administration, the Biden-Harris administration, takes global health security very, very seriously.   

So we will continue to support the Government of DRC in several ways.  We started donating vaccines.  We’ve had teams from our agencies – CDC, USAID – on the ground supporting DRC in surveillance, lab testing, and other efforts.   

Again, as I indicated earlier, our efforts to supporting global health security and specifically the mpox in the region didn’t start today.  We have invested over 2.65 billion in Fiscal Year 2023 alone in supporting countries to build their capacity so that they can better respond to this kind of outbreaks. 

The longstanding partnership that we’ve built we hope over the last 20 years in fighting several diseases, including HIV, which we’ve invested over 100 billion over the last 20 years, will definitely provide strong capacity for surveillance, infection control and prevention, and laboratory testing to all the countries that are affected. 

The United States, as I indicated, is mobilizing additional resources.  The USAID just announced $35 million, and again, we will stay committed until we bring this outbreak to – control it in collaboration, of course, with others: the WHO and Africa CDC.  

MODERATOR:  Thank you, Ambassador.  The third question that we have for you today, Ambassador, is from Dorcas Wangira from BBC, Kenya, and they ask:  “Besides the DRC, which other African countries has the United States pledged to donate vaccines?”  

AMBASSADOR NKENGASONG:  Thank you so much for the question.  The United States has also donated vaccines to Nigeria, and as this outbreak continues we are monitoring it very, very closely.  And as I indicated earlier, it’s a question of working collaboratively with WHO, Africa CDC, and other partners to bring this outbreak to a closure.  We cannot lead with mpox (inaudible).  So regardless of where the virus occurs, we will continue to use our existing investments in those countries that we already have assets, global health security assets, in response to TB, malaria, and HIV to support countries, partner countries to respond.   

So vaccines is not the only tool that is required here.  We really need an integrated approach in fighting this outbreak, so that vaccine is one component, or rather one tool in the menu of tools that is required to effectively bring mpox under control.  So we are committed to supporting countries, partner countries that we already have a lot of investment in global health security equity. 

MODERATOR:  Thanks, Ambassador, for that.  Now we’ll go to our live questions.  And there’s a question from Colbert Gwain, and he asks – from Cameroon – and he asks:  “Is there any relationship between mpox and HIV/AIDS?” 

AMBASSADOR NKENGASONG:  Again, remember, this is still what we are seeing in DRC and other countries is relatively – I would call it relatively new virus in terms of what – the size of this outbreak.  And we are working very closely to understand the relationship between mpox, especially the clade Ib, and HIV infection.  But clearly we know that HIV leads to immunosuppression.  That means that your immune system is weakened, and any other virus that infects anyone with a weakened immune system ultimately aggravates the situation.  So again, we are – we have to be very, very cognizant of that, and with the understanding that new scientific studies are going on to characterize the virus and to characterize the interaction between mpox and HIV. 

MODERATOR:  Thank you.  Our next question comes from Mr. Ibrahim Ndiaye, from Senegal.  And he asks:  “What are the risks of mpox spreading in other parts of the African continent?” 

AMBASSADOR NKENGASONG:  As we all know, the mpox is already spreading in several countries in Africa.  And as people travel and move around, you expect mpox to continue to spread in several parts of Africa – not just Africa, but in the world.  We also know that this particular clade – the clade Ib – has also been detected in Sweden and in Thailand through travel-associated means.  So again, we just have to be vigilant and show that we have strong surveillance systems that can pick up the virus early and control measures put in place. 

Let me just say this: that this is an outbreak that is very different from COVID.  COVID was a respiratory infection that spread very, very fast.  I think with this virus, it requires contact.  We know there is sexual transmission.  There’s very – it requires very, very close contact, human-to-human contacts, for transmission to occur.  So we’ll continue to see this, but I want to really let everyone know that we should be assured that everything possible is being done to fight the outbreak.  It is not a respiratory virus.  In other words, if you move around an area where someone with mpox has been around, you cannot breathe it in.  You cannot breathe it in.  So again, let’s just be calm and understand that there’s effective coordination going on with WHO and other agencies like Africa CDC to bring the virus under control. 

MODERATOR:  Thank you.  A fourth question for this briefing is:  “Do we know – what do we know about the new clade Ib variant of the mpox that is now in Central Africa?” 

AMBASSADOR NKENGASONG:  Yeah.  We know, as I indicated, that this is a clade that is different from the clade II.  And this is associated – this clade Ib has been associated with transmission through intimate and other sexual contact, including heterosexual spread of the virus.  It has a lower case fatality rate compared to clade Ia.  So that’s all we know – we know for now.  I think all of this – the nomenclature, clade Ia and b, is based on understanding the genetic material of the virus and how that differs – how far they are apart.  Again, this is all we know for this clade for – at the moment, and science – as we continue to respond to the outbreak, we’ll continue to generate new data that would teach us what we call the pathogenesis.  That is the ability for the virus to infect people and to cause disease. 

MODERATOR:  Thank you, Ambassador.  Now to our sixth question, and the question comes from the DRC again, and it says:  “There are rumors that the U.S. may impose restrictions on travelers from African countries.  Will this lead to mandatory vaccinations for travelers to the U.S., similar to the covid 19 requirements?” 

AMBASSADOR NKENGASONG:  No, the U.S. currently do not plan to put in place travel restrictions for people traveling from Africa.  So that is really a rumor.  So we do not at this point think that is going to happen. 

MODERATOR:  Great.  I’d like to now turn it to our journalists who are now live on the call, and we’d like to give Janice Kew from Bloomberg an opportunity to ask more about the vaccines. 

QUESTION:  I just wanted to follow up on – I appreciate fully that vaccines are just one measure.  I believe that the U.S. has about 5 million vaccines stockpiled.  And I was just wondering if, in the next while, there might be hope that maybe half of that would be donated or something similar.  Sixty thousand is appreciated, but it seems like a fairly small amount if you think what the stockpile is likely to be.  And I mean, arguably, this is – this particular outbreak wouldn’t have happened or maybe wouldn’t have happened to this extent if vaccines had been on the ground back in 20 – like two years ago.  So I’m just wondering what your thoughts are around that, again, acknowledging that vaccines aren’t the only problem here and not the only solution either. 

AMBASSADOR NKENGASONG:  I think one of the lessons we’ve learned over the years in fighting diseases like Ebola outbreak in DRC and COVID more generally, when COVID happened, is that we have to have the vaccines but also focus on the vaccination itself – and strengthen systems that will bring – make sure that the vaccines that we already have are actually deployed in the field.  And as I indicated earlier, we have to have an integrated approach, which includes surveillance.  This is a disease that I really want to emphasize and underline this is not a respiratory virus.  This is not a disease that we are seeking to vaccinate the entire population that we were trying to do during the COVID response.  It has to be very targeted and guided by surveillance, which is we know who is infected, you start off with that household and the community in – almost what you call the ring vaccination there. 

So the most important thing is to make sure that the response is integrated and make sure that the vaccines that are already there are being used in the theater of response.  The U.S., as you recalled, during the COVID pandemic donated over 700 million safe and effective vaccines to 117 countries.  As the – as this outbreak continues, the U.S., as I indicated previously, will continue to avail vaccines, especially ones – those that have gone through the WHO pre-qualification process. 

MODERATOR:  Thank you, Ambassador.  Ambassador, we’ll go to a question from the DRC again, from Guillaumette Kabemba from Buzz FM.  And they ask:  “The rumor has it that the mpox vaccine can only be used in Africa.  Is this true?” 

AMBASSADOR NKENGASONG:  No, it’s not true at all.  And again, as the previous colleague just talked about, the vaccines that we are sharing are vaccines that are available everywhere and will be used everywhere where need arises.  So no, it’s not true. 

MODERATOR:  Great.  Thank you so much, Ambassador, for that.  Now we’ll go back to the DRC again.  We have a big contingent from the DRC who are very much interested in this briefing and the impact of mpox in their communities.  And they ask, can – this from Felly Luyindadio from Nouvel Observateur (inaudible) in DRC.  And they ask:  “Can the U.S. build the capacity of Congolese researchers and physicians to combat – and more importantly, prevent – recurrent epidemics such as mpox and Ebola in the DRC?” 

AMBASSADOR NKENGASONG:  That is a very good question.  As I said earlier, our partnership with DRC didn’t start today.  We have been in DRC for many, many years.  I mean, we currently – just the HIV platform, we currently availed to the DRC more than $90 million a year just to support DRC to strengthen their capacity to fight HIV/AIDS, and of course, in doing that, support emerging infections like Ebola, COVID.  If you recall that during the COVID outbreak, there is – the same systems and structures that we have supported over many, many years, we have used effectively in responding to the COVID outbreak in DRC.  That included laboratory testing, expansion of vaccination and distribution there.   

So again, it’s a very strong partnership that goes a long, long way.  It’s – it doesn’t start today.  So we have every reason to continue to celebrate that relationship and partnership because that is so important.  (Inaudible) before you get tested.  So, I mean, we have been investing in global health security assistance in DRC for many, many years.  I think – and this is a time to turn those assets that we have had in place over the years and make it work for mpox.   

MODERATOR:  Thank you, Ambassador.  I think we have time for one last question, and this one – this question goes – excuse me – back to – back to the DRC.  And they ask:  “People could choose from a variety of vaccines during the COVID-19 pandemic.  Do people have the same opportunity as far as the mpox outbreak is concerned?”  

AMBASSADOR NKENGASONG:  Again, let me just emphasize this, that during COVID pandemic, we had about four or five different vaccines that were available.  And always remember that the target was to vaccinate almost 60 to 70 percent of the population.   

This is not the case.  This is not the case where we are striving to vaccinate 70 percent of the population in DRC.  It’s going to be very, very targeted, and that is the most effective use of the vaccine, just in what we call in public health ring vaccination where you first of all identify where the patient is through good surveillance and lab testing, and then you can zone that area and vaccinate, and vaccinate them using the available vaccines that are there.  So I think it’s very, very different from COVID, which is – was a respiratory infection and respiratory infections tend to spread very, very quickly, as we know.  The case fatality rate – that is, the mortality, the number of people dying of COVID – as you know, was very, very high.   

So again, I just want to assure everyone that the tools that we are deploying in the theater of response, we collectively – WHO, the Government of DRC, and other countries, including Africa CDC – will lead ultimately to our ability to contain this virus.   

MODERATOR:  Thank you.  Ambassador, do you have any final words for us today? 

AMBASSADOR NKENGASONG:  Yeah, just again to say that this is a reminder that we live in a world now where outbreaks and disease threats are very common.  Just last year in 2002 – 2022, we’re dealing with the clade II mpox and now we’re dealing – we have evidence with clade I virus which is causing higher number of severe infections and higher mortality rates than the clade IIb, so which is, again, a new finding that we are seeing.  When we had the IIb clade, it spread very quickly across the world, but it had a lower mortality rate.  This time around, you’re seeing a virus that has mutated and is causing severe infections and a higher mortality rate than the clade II. 

So again, I emphasize that just to say that we have to be vigilant but not panic.  We cannot panic.  This is – we have the public health tools available to work together in a coordinated way and bring this outbreak to a closure.  It’s an outbreak.  It’s not yet a pandemic.  And we are tracking that.  We have the appropriate tools in the theater of response in DRC and in many countries that already have seen an increased number of this virus circulating.  

MODERATOR:  Thank you, Ambassador.  Well, that concludes today’s briefing.  I want to thank U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy, Ambassador John Nkengasong, for joining us.  Thank you to all the journalists for participating.  A recording and transcript of today’s briefing will be distributed to participating journalists as soon as we can produce them.  If you have any questions about today’s briefing, you may contact the Africa Regional Media Hub at AFMediaHub@state.gov.  I would also like to thank – I would also like to invite everyone to follow us on Twitter at our handle @AfricaMediaHub.  Thank you. 

AMBASSADOR NKENGASONG:  Thank you.  Thank you all for contributing this morning.