Activists and public health experts in Mexico demand that officials of the Mexican Ministry of Health (SSA) and the Federal Commission for the Protection against Sanitary Risks (COFEPRIS) authorize the use of monkeypox (mpox) vaccines in the country.

"Despite the fact that mpox was declared a Public Health Emergency of International Concern by the World Health Organization (WHO) in July 2022, the vaccine recommended by the WHO to prevent infections is not yet authorized for use in Mexico," said Dr. Jorge Saavedra, Executive Director of the AHF Institute for Global Public Health, and one of the authors of the reply letter published in The Lancet Regional Health Americas. Dr. Saavedra added, “Strangely, Mexico is the only country in the top 10 with the most accumulated cases of mpox, which has not authorized the vaccine, as the other top nine have: USA, Brazil, Spain, UK, Colombia, Germany, France, Peru and Canada.”

In the current outbreak, mpox has disproportionately affected gay and bisexual men and severely affected those with advanced HIV, including cases that ended in death.

To deal with this health emergency, the WHO and the Centers for Disease Control have recommended the use of the vaccine for people at higher risk of exposure. The European Medicines Agency and the US FDA have also authorized the use of the vaccine.

Curiously, mpox vaccines were also recommended by officials of the Mexican Ministry of Health as a measure to contain the disease in a study published by the prestigious journal The Lancet. These officials, in their capacity as authors, correctly pointed out that the measures containment programs should, whenever available, include vaccines targeted at higher-risk groups. Among the authors of this study is the highest decision-maker in public health in Mexico, Dr. Hugo López-Gatell, Undersecretary of Health.

Dr. Gatell and the other authors of this study, which include Dr. Gustavo Reyes Terán (Head of the Coordinating Commission of National Institutes of Health and High Specialty Hospitals), Dr. Alethse de la Torre (General Director of the National AIDS Center-CENSIDA), who is in charge of HIV and STI policies and creating communication materials on mpox, as well as Dr. Gabriel García Rodríguez (General Director of Epidemiology) are the heads of the formulation of mpox policy in Mexico.

“It is disconcerting that Dr. López Gatell and these high level officials of the Ministry of Health, who are authors of this study, recommend the use of vaccines when addressing an international audience of health professionals through The Lancet, but they refuse to authorize any use of the mpox vaccine in their own country,” says Alain Pinzón of VIHve Libre, a local NGO that advocates for an effective response to HIV and mpox. “They say that there is not enough scientific evidence to authorize the vaccine, but they promoted the authorization in Mexico of the Chinese, Russian and Cuban vaccines against Covid-19, which had much less scientific evidence; so, for many of us, this not only sounds like hypocrisy, but institutional homophobia,” concluded Mr. Pinzón.

Human rights and public health activist Dr. Ricardo Baruch, another author of this letter, who has been pushing for the vaccine to be licensed since the beginning of this outbreak, says, “When we first read the article, we are very encouraged because high-level officials from the Mexican Ministry of Health expressed an opinion that was fully aligned with our advocacy efforts, as well as with the recommendations of the WHO, the EU and the CDC. However," he continues, "This was not what happened: Despite trying to raise awareness among officials in many ways, they have been reluctant to authorize its use."

After many unsuccessful attempts to convince Ministry of Health officials to follow the science and approve the use of mpox vaccines in Mexico, activists and public health professionals decided to write a reply to The Lancet to highlight the contradiction and express their concern. The letter was accepted and finally published by the same magazine in its correspondence section titled "MPOX vaccines are needed in Mexico,” on March 6, 2023. The authors of the letter highlight the discrepancy between words and actions and that, to date, mpox vaccines are not yet authorized for use by any person at serious risk in the country and they have not been purchased from the public sector either.

It has been demonstrated that vulnerable populations in Mexico need access to this vaccine that saves lives in the most serious cases and avoids unnecessary suffering in mild or not-so-serious cases. Currently, the only Mexicans who have been able to get vaccinated against mpox are those who have had money and/or a visa to travel to the United States, Canada, or Europe.

Mpox is a viral disease that was rarely seen outside of Africa until last year but has since affected more than 86,000 people in more than 110 countries and territories. Among the countries most impacted by the disease is Mexico, which has repeatedly been among the top ten countries, not only with the highest number of accumulated cases of mpox since the beginning of this outbreak, but also with the highest number of new cases in 2023.

AIDS Healthcare Foundation (AHF) is a global non-profit organization providing cutting-edge medicine and advocacy to over 1.7 million people in 45 countries worldwide in the US, Africa, Latin America/Caribbean, the Asia/Pacific Region, and Europe. We are currently the largest non-profit provider of HIV/AIDS medical care in the world. To learn more about AHF, please visit our website: www.aidshealth.org, find us on Facebook: www.facebook.com/aidshealth and follow us on Twitter: @aidshealthcare and Instagram: @aidshealthcare.

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