Why monkeypox vaccines are so hard for countries to get : Goats and Soda Only one company makes the currently used monkeypox vaccine. Supply is limited in wealthy nations like the U.S. Less well-off nations, like Nigeria, where the outbreak began, have no vaccines at all.

Is there enough monkeypox vaccine to go around? Maybe yes, more likely no

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LEILA FADEL, HOST:

As the number of monkeypox cases climbs, now nearing 12,000 in the U.S., the federal government is pledging up to 442,000 doses of vaccine to fight the outbreak. That's two times the doses that were originally expected. But what's available for the rest of the world? Joining us to talk about this is NPR global health correspondent Nurith Aizenman. Hi, Nurith.

NURITH AIZENMAN, BYLINE: Hi, Leila.

FADEL: So the COVID pandemic really showed us how vaccines are not distributed equally to all countries. Is that happening again with monkeypox?

AIZENMAN: Well, you know, while it's too early to say for sure that it's going to play out that way, that does seem to be a real risk. Of course, in contrast to COVID, the monkeypox outbreak is affecting far fewer people. We're talking an order of magnitude of 30,000 confirmed cases worldwide right now. And the vaccination campaigns are focused on a much smaller target group. This outbreak has been largely driven by spread of the virus among men who have sex with men. Still, even with that more narrow focus, even wealthy countries like the U.S. are struggling to get enough vaccine. And that's because, in practice, there's really just one vaccine that countries are looking to, and there's only one company in the world that makes it - a Danish company called Bavarian Nordic.

FADEL: Just one company?

AIZENMAN: Right. And they're still ramping up their capacity.

FADEL: OK. So which countries are getting that vaccine?

AIZENMAN: OK, first, I need to add the caveat that not all the data on this is publicly disclosed. So the numbers can get a bit squishy. But the U.S. appears to have snapped up the largest quantity of Bavarian Nordic's upcoming supply through contracts that actually largely date back years. And there's been a rush by a handful of other wealthy countries, like the U.K. and Germany, to secure contracts. Now, the Pan American Health Organization announced recently that they brokered a contract on behalf of some Latin American countries, including Brazil, which has one of the world's biggest outbreaks. But that quantity doesn't appear to be very large, and this still leaves many more countries without any apparent access, particularly low-income ones. And in Africa, there's no vaccination going on right now.

I spoke with Dr. Phionah Atuhebwe. She coordinates the introduction of new vaccines in Africa for the World Health Organization. And she told me that the lack of supply is actually one of the reasons they're not pushing vaccination as a strategy in Africa right now.

PHIONAH ATUHEBWE: We would definitely be more than glad to ensure that they have vaccines on standby for the high-risk populations to be vaccinated. But we know at the moment, that is not possible given the stockpile.

AIZENMAN: Then again, she also notes that the monkeypox outbreaks in Africa are somewhat different.

FADEL: Oh, what do you mean?

AIZENMAN: So monkeypox has actually been percolating in some African countries for years now, with fairly limited outbreaks. In fact, studies suggest this current global spread began in Nigeria. But that said, in Africa, at least for now, there doesn't seem to be the kind of explosive spread among men who have sex with men that's characterized this outbreak in the U.S. and Europe. Of course, African countries might be missing cases. There are fewer resources to be able to test.

And in many of these countries, gay men are persecuted. I mean, dozens of countries around the world have laws criminalizing homosexuality, and that's certainly the case in Africa. So that could be deterring people with monkeypox from coming forward. But, you know, even if the case counts in Africa really are as low as they appear, that's not to say that the outbreaks in the U.S. and Europe couldn't get imported back to Africa.

FADEL: NPR's Nurith Aizenman, thank you so much.

AIZENMAN: You're welcome.

(SOUNDBITE OF ARMS AND SLEEPERS' "WHEN THE BODY")

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