Global Mpox Vaccine Stockpile Launched to End Emergency Scramble

What the new initiative means

On 27 August, a major new global initiative was launched to create a standing stockpile of mpox vaccines, a move designed to replace the chaotic, ad hoc procurement that has characterized previous outbreak responses with a reliable, long-term access mechanism. The announcement, confirmed by the World Health Organization (WHO), signals a structural shift in how the international community prepares for and responds to the disease, which has repeatedly tested public health systems in Africa and beyond.

At its core, the initiative will establish a centralized reserve of vaccine doses that countries can draw upon when an outbreak occurs, rather than scrambling to negotiate supply contracts under emergency conditions. This approach mirrors existing mechanisms for cholera, yellow fever and meningitis, but until now no comparable system existed for mpox. The WHO is central to the coordination effort, working with a broad coalition of international health and vaccine partners to finance, manage and deploy the stockpile over time.

Why the stockpile is needed

Mpox, formerly known as monkeypox, gained global attention during the multi-country outbreak of 2022, which spread to regions where the virus was not traditionally endemic. That episode exposed stark inequities in vaccine access: wealthy nations rapidly secured doses of the MVA-BN smallpox vaccine—the primary vaccine used against mpox—while many low- and middle-income countries, particularly in Africa where the disease has been circulating for decades, were left without supplies for months.

“The outbreak showed us that relying on emergency procurement alone is not a sustainable strategy,” a senior health official familiar with the initiative commented, speaking on condition of anonymity because the operational details are still being finalized. “A stockpile that sits ready for deployment changes the entire timeline of response.”

The new mechanism is therefore as much about equity as it is about preparedness. By pre-negotiating supply agreements, maintaining buffer stocks and establishing transparent allocation rules, the initiative aims to ensure that at-risk populations across all regions receive vaccines swiftly, regardless of their country’s purchasing power or geopolitical leverage.

Who will manage and fund the stockpile

While exact governance structures are still being shaped, the initiative brings together key players from the global health architecture. The WHO will provide technical leadership and coordinate the allocation process, likely drawing on its experience with the International Coordinating Group (ICG) on Vaccine Provision. The ICG already manages emergency stockpiles for yellow fever, meningitis and cholera, and its model—under which countries submit requests that are evaluated based on epidemiological need and response capacity—is expected to inform the mpox framework.

Financing is expected to come from a mix of donor governments, multilateral development banks and philanthropic foundations, while vaccine manufacturers will be asked to set aside a portion of their production for the stockpile. The Africa Centres for Disease Control and Prevention (Africa CDC), which has long advocated for a regional manufacturing hub and more equitable vaccine distribution, is seen as a critical partner for both ground-level logistics and political advocacy. Gavi, the Vaccine Alliance, may also play a role in procurement and delivery, bringing its expertise in managing large-scale vaccine programmes.

Regulatory support will be essential as well. The stockpile can only function if vaccines are licensed or granted emergency use authorization in the countries that request them. The WHO’s prequalification and Emergency Use Listing procedures will help accelerate these approvals, while regional bodies such as the African Medicines Agency could streamline national registrations.

How doses will be allocated

Details of the allocation criteria are still under discussion, but the guiding principle is clear: doses should go where the epidemiological risk is highest. Early indications suggest that requests will be triaged based on the pattern of active transmission, the size and vulnerability of the affected population, and the capacity of local health systems to mount a vaccination campaign. The mechanism is also likely to reserve a contingency tranche for sudden flare-ups, ensuring that even small, unexpected outbreaks can be contained before they escalate into larger epidemics.

In addition to outbreak response, the stockpile may support preventive vaccination for high-risk groups such as healthcare workers, laboratory personnel and contacts of confirmed cases. This dual-use strategy—both reactive and preemptive—would mirror the approach recommended by the WHO’s Strategic Advisory Group of Experts on Immunization (SAGE) for mpox vaccines.

What comes next

The launch on 27 August is only the starting point. In the coming weeks, WHO will convene technical consultations with member states, manufacturers and funders to iron out the stockpile’s operational blueprint. Critical questions remain: where the physical stocks will be warehoused, how shelf-life and cold-chain requirements will be managed, and what legal framework will govern liability and compensation in the event of adverse events following immunization.

For countries that have struggled to access mpox vaccines, the initiative offers a tangible path toward greater health security. By transforming a reactive, winner-takes-all scramble into a predictable, rules-based system, the global stockpile could become a template for managing future emerging infectious disease threats, reinforcing the hard-learned lesson that no nation is safe until all nations are protected.