Monkeypox can be a serious infection, with mortality rates from this type of monkeypox virus having been around 1 % in other outbreaks. These are often in lower-income settings with limited access to health care.

Michael Head

In a lot of countries around the world there will be people who are unvaccinated or with one dose ; across South Africa most people have not yet had two doses, so we need to look a little bit about whether there's any protection, some protection... in those populations too.

I imagine Omicron will be everywhere soon, and there'll be a lot of Omicron around that most countries haven't detected yet, in part because testing systems and genomic capacities may be limited.

I think scientifically at the minute there is a very strong argument for more interventions in place, but politically that's less acceptable.

Vaccine inequity... will prolong the pandemic, the best way to be selfish.

The problem is the people with the power are predominantly national governments, the WHO offers guidance, but it doesn't have much power. And it's the WHO that works on things like equity to ensure that the world is as protected as it can be.

In between pandemic times, we must learn lessons about improving infrastructure for research across low and lower-middle income settings, we need several large hubs, manufacturing sites across Africa and Southeast Asia and South America that are able to develop at large scale vaccines and diagnostics and therapeutics, and with the paperwork in place as well.