Mpox Vaccine Equity

After two global emergency declarations for mpox (formerly monkeypox), vaccines against the virus finally began reaching African countries in 2024. Public Citizen’s several years of mpox work helped mobilize a large U.S. government interagency task force, force vaccine price reductions for UNICEF and Gavi, the Vaccine Alliance, and produce a manufacturing deal with a producer in India to increase supply. 

During the 2022 mpox outbreak, Public Citizen traced how public scientists and public money helped develop the Jynneos mpox vaccine that the manufacturer, Bavarian Nordic, was charging poor and rich countries $100 or more per dose – an outrageous price that limits access for developing nations. The U.S. government has provided $2.4 billion to Bavarian Nordic for the development and purchase of Jynneos.

We calculated that the U.S. held nearly 80 percent of the global vaccine supply, demonstrated that developing country manufacturers sell vaccines using a similar production process as Jynneos for $4 or less per dose, and called for a White House global plan of action to prevent disease spread and expand global vaccine production capacity. When a deadly new outbreak led to the 2024 mpox emergency, the world still was very poorly prepared and no mpox vaccines had yet reached African countries — including those countries where mpox is endemic. But the U.S. had formed a mpox task force involving multiple government agencies and the White House and announced support for the outbreak in Africa, including a donation of up to one million vaccine doses, while multinational and regional health organizations worked with countries to help mobilize a coordinated response.

The 2024 mpox outbreak was marked by deep inequity in access to vaccines. The Africa Centers for Disease Control called for 10 million doses of vaccine to be distributed. Public Citizen and other health groups wrote UNICEF and Gavi, calling for transparency in contract negotiations and urging them to use their purchasing power to negotiate affordable prices to help meet the overwhelming need. We called out Bavarian Nordic’s pricing and UNICEF and Gavi made use of our advocacy to lower prices. UNICEF announced a deal with a price of  $65 per dose, which UNICEF called “the lowest price on the market.” This was an improvement, though still an exceedingly high price for a vaccine in low-resource settings, with no cost justification from Bavarian Nordic. Indeed, it is the second highest price UNICEF pays for any vaccine. We found that Bavarian Nordic had charged UNICEF about $10 more per dose than it charged the United States, and noted that poor countries should not pay more than rich countries for vaccines. 

Public Citizen and others called on Bavarian Nordic to amend its contract with UNICEF to better meet health needs and to enable longer-term access to mpox vaccines including by engaging in affirmative technology transfer with LMIC manufacturers. Bavarian Nordic later announced a manufacturing deal with the Serum Institute of India to increase supply.

In 2025, Public Citizen analyzed the shortfall and pointed out Africa had nearly 400 times fewer vaccine doses per mpox case as the U.S. had at the height of its 2022 mpox emergency and underscored that the Trump administration’s cuts to foreign assistance and its halting of work with the World Health Organization threatened the health of people everywhere, including by its potential to compromise the mpox response.

As of December 2025, nearly 2 million doses of Jynneos have been delivered across 16 countries in Africa.

Mpox shows that the world’s poor continue to be neglected and shoved to the back of the line, without access to existing medical tools, and that is something we cannot accept. The public has invested more than $2 billion developing and supporting the mpox vaccine Jynneos. Yet one corporation, Bavarian Nordic, controls the vaccine and keeps its price outrageously high. We’re fighting this and making a lifesaving difference. The mpox vaccine should belong to all people, everywhere, and be available for African manufacturers to help meet local need and encourage ambitious campaigns to protect people from this devastating disease. Peter Maybarduk, Public Citizen's Access to Medicines Director