U.N. member states ended two weeks of negotiations Friday without a treaty to protect biodiversity in the high seas, an agreement that would have addressed growing environmental and economic challenges.

After 15 years, including four prior formal sessions, negotiators have yet to reach a legally binding text to address the multitude of issues facing international waters — a zone that encompasses almost half the planet.

“Although we did make excellent progress, we still do need a little bit more time to progress towards the finish line,” said conference chair Rena Lee.

It will now be up to the U.N. General Assembly to resume the fifth session at a date still to be determined.

Many had hoped the session, which began on Aug. 15 at the United Nations headquarters in New York, would be the last and yield a final text on “the conservation and sustainable use of marine biodiversity beyond national jurisdiction,” or BBNJ for short.

“While it’s disappointing that the treaty wasn’t finalized during the past two weeks of negotiations, we remain encouraged by the progress that was made,” said Liz Karan with the NGO Pew Charitable Trusts, calling for a new session by the end of the year.

One of the most sensitive issues in the text revolved around the sharing of possible profits from the development of genetic resources in international waters, where pharmaceutical, chemical and cosmetic companies hope to find miracle drugs, products or cures.

Such costly research at sea is largely the prerogative of rich nations, but developing countries do not want to be left out of potential windfall profits drawn from marine resources that belong to no one.

‘Missed opportunity’

Similar issues of equity arise in other international negotiations, such as on climate change, in which developing nations that feel outsized harm from global warming have tried in vain to get wealthier countries to help pay to offset those impacts.

The high seas begin at the border of a nation’s exclusive economic zone (EEZ) — which by international law reaches no more than 200 nautical miles (370 kilometers) from its coast — and are under no state’s jurisdiction.

Some 60% of the world’s oceans fall under this category.

And while healthy marine ecosystems are crucial to the future of humanity, particularly to limit global warming, only 1% of international waters are protected.

One of the key pillars of an eventual BBNJ treaty is to allow the creation of marine protected areas, which many nations hope will cover 30% of the Earth’s ocean by 2030.

“Without establishing protections in this vast area, we will not be able to meet our ambitious and necessary 30 by 30 goal,” U.S. State Department official Maxine Burkett said at an earlier press conference.

But delegations still disagree on the process for creating these protected areas, as well as on how to implement a requirement for environmental impact assessments before new activity on the high seas.

“What a missed opportunity…” tweeted Klaudija Cremers, a researcher at the IDDRI think tank, which, like multiple other NGOs, has a seat with observer status at the negotiations.
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The head of the U.S. Centers for Disease Control and Prevention (CDC) said Friday that very few people in the United States have received a full series of monkeypox vaccinations.

CDC Director Rochelle Walensky said the large majority of Americans who received a first dose of the vaccine have yet to get their second dose, despite being eligible.

She told a White House briefing Friday that nearly 97% of the inoculations administered so far have been first doses.

Walensky said that while the vaccine was initially hard to get, supplies have now increased.

Earlier this month, the U.S. Food and Drug Administration (FDA) allowed for the vaccine to be injected in smaller doses to help stretch supplies.

The Biden administration says it has shipped enough vaccines to jurisdictions around the United States for at least 1.6 million doses.

CDC data show that about 10% of monkeypox vaccine doses have been given to Black people despite the fact that they account for one-third of U.S. cases.

The rate was compiled from 17 U.S. states and two cities.

Walensky said the CDC has taken measures to make the vaccine more accessible to Blacks and other minorities. She said vaccines and educational materials will be available at two upcoming events — Atlanta’s Black Pride festival and New Orleans’ Southern Decadence.

Walensky said the agency is starting to roll out such pilot projects and that “they are working.”

Most cases of monkeypox in the United States have occurred in gay men, but health officials have stressed that anyone can catch the virus.

More than 16,000 people have been infected with the virus in the United States, more than in any other country.

Walensky noted that the spread of the virus is falling in several major U.S. cities.

“We’re watching this with cautious optimism, and really hopeful that many of our harm-reduction messages and our vaccines are getting out there and working,” she said.

Across the United States, cases of monkeypox are still increasing. However, officials say the pace of the outbreak appears to be slowing.

On Thursday, the World Health Organization said global cases of monkeypox dropped 21% in the past week.

The WHO said cases appeared to be slowing in Europe but warned that infections in the Americas were on “a continuing steep rise.”

“In Latin America in particular, insufficient awareness or public health measures are combining with a lack of access to vaccines to fan the flames of the outbreak,” WHO Director-General Tedros Adhanom Ghebreyesus told a press briefing.

Monkeypox has been endemic in parts of Africa for decades, but since May, cases have been reported around the world.

The virus is typically spread by skin-to-skin contact with an infected person’s lesions. It can also be spread through contact with an infected person’s clothing or sheets.

Some information for this report came from The Associated Press and Reuters.
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The first crewed flight of Boeing’s space capsule Starliner is scheduled for February 2023, the company and NASA announced Thursday, as the United States seeks to secure a second way for its astronauts to reach the International Space Station.

Since 2020, American astronauts have traveled to the ISS aboard SpaceX’s vessels, but the U.S. space agency wants to widen its options.

After a series of hiccups in its space program that led to serious delays, including a 2019 flight that did not reach the ISS, Boeing finally managed to send the gumdrop-shaped capsule to the station in May — without a crew.

This time, the aerospace giant will send up the Starliner with humans aboard to earn NASA’s green light to begin regular missions at an expected pace of one per year.

“Currently, we’re targeting a launch date as early as February of 2023,” Steve Stich, manager of NASA’s Commercial Crew Program, told reporters.

“We’re in good shape to execute these plans to be ready for that flight in February,” added Mark Nappi, Starliner program manager at Boeing.

The test flight — aptly named CFT, or Crew Flight Test — will carry U.S. astronauts Barry Wilmore and Sunita Williams.

They are expected to be docked for eight days at the ISS, where they will conduct a series of experiments, said ISS program manager Joel Montalbano.

“Our agency goal is to get two U.S. commercial providers up and running as soon as we can.”

Boeing had hoped to conduct this test flight before the end of the year, but a few glitches experienced in the uncrewed May flight led to necessary adjustments to the vessel.

An issue was detected in the propulsion system: two thrusters responsible for placing Starliner in a stable orbit failed, though officials insisted there was plenty of redundancy built into the system to overcome the problem.

Boeing’s teams later determined that “debris-related conditions” were to blame, Nappi said, adding that the origin of said debris was still unknown.

Some filters were removed to fix a pressure problem, and flight software was updated to avoid a data overload.

Boeing and SpaceX were awarded contracts in 2014, shortly after the end of the space shuttle program, during a time when the United States was left reliant on Russian Soyuz rockets for rides to the ISS.

Elon Musk’s SpaceX filled the void first, providing space “taxi” service since a successful test mission for its Dragon capsule in 2020.
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The World Health Organization (WHO) said Thursday the number of new monkeypox cases fell 20% globally last week, but new cases increased in the Americas and said there is still “intense transmission” of the disease.

At a news briefing at agency headquarters in Geneva, WHO Director-General Tedros Adhanom Ghebreyesus said there are signs the monkeypox outbreak is slowing in Europe, which he credited to a combination of effective public health measures, changes in behavior and vaccination.

But the WHO chief said the opposite is true in the Americas, particularly in Latin America, where insufficient awareness or public health measures are combining with a lack of access to vaccines to “fan the flames of the monkeypox outbreak.”

Tedros said in the early stages of the monkeypox outbreak, most reported cases were in Europe, with a smaller proportion in the Americas. He said, “That has now reversed, with less than 40% of reported cases in Europe and 60% in the Americas.”

The WHO chief said Danish drug maker Bavarian Nordic signed an agreement Wednesday with WHO affiliate the Pan-American Health Organization to support access to its vaccine in Latin America and the Caribbean.

Tedros also noted that this week, globally, the world crossed another tragic milestone, with 1 million reported COVID-19 deaths in 2022.

He said, “We can’t say we are learning to live with COVID-19 when 1 million people have died with COVID-19 this year alone, when we have all the tools necessary to prevent these deaths.”

The WHO director-general, once again, asked “all governments to strengthen their efforts to vaccinate all health workers, older people and others at the highest risk, on the way to 70% vaccine coverage for the whole population.”

Some information for this report came from Reuters and Agence France-Presse.
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North Korea on Thursday said it found four new fever cases in its border region with China that may have been caused by coronavirus infections, two weeks after leader Kim Jong Un declared a widely disputed victory over COVID-19.

North Korea’s state-run Korean Central News Agency said health workers were conducting genetic tests on the samples taken from four people in Ryanggang province who exhibited fevers to confirm whether they were caused by the “malignant epidemic.” The North often uses that term, along with “malignant virus,” to describe COVID-19 and the coronavirus.

Authorities immediately locked down the areas where the fever cases emerged and plan to maintain tight restrictions and quarantines until health workers determine the cause of the illness.

KCNA said health authorities were giving extra attention to the cases because none of the four patients had a history of coronavirus infections.

The country’s emergency anti-virus headquarters dispatched “talented epidemiological, virology and test experts to the area” and is taking steps to “trace all persons … connected with the suspect cases, and persons going to and from the relevant area and keep them under strict medical observation,” KCNA said.

North Korea said there have been no confirmed COVID-19 cases in any part of the country since Aug. 10 when Kim declared victory over the virus, just three months after the country acknowledged an outbreak.

Even as he ordered preventive measures eased, Kim called for vigilance and the maintaining of tight border controls to prevent the virus from reentering the country. Ryanggang province is one of the border areas where North Korean officials for years struggled to clamp down smuggling activities with China.

An official from South Korea’s Unification Ministry, which handles inter-Korean affairs, said Seoul isn’t ruling out the possibility that the virus could reemerge in the North.

“North Korea may additionally report on the situation, including whether the fevers were confirmed as COVID-19, and we would need to wait for that before making judgments,” said the official, who spoke on condition of anonymity during a background briefing.

While Kim claimed that the country’s success against the virus would be recognized as a global health miracle, experts believe the North has manipulated disclosures on its outbreak to help him maintain absolute control. The victory statement signals Kim’s aim to move to other priorities, including a possible nuclear test, experts say.

After admitting to an omicron outbreak of the virus in May, North Korea reported about 4.8 million “fever cases” across its mostly unvaccinated population of 26 million but only identified a fraction of them as COVID-19. It claimed just 74 people have died, which experts see as an abnormally small number considering the country’s lack of public health tools.

Kim’s declaration of victory over COVID-19 during a national meeting in Pyongyang was followed by a combative speech from his powerful sister, who said Kim had suffered a fever himself while steering the anti-virus campaign and laid dubious blame against South Korea while vowing deadly retaliation.

North Korea claims that its initial infections were caused by anti-Pyongyang propaganda leaflets and other items carried across the border by balloons launched by South Korean activists, a claim the South has described as “ridiculous” and unscientific.

Outside experts believe it’s more likely that the virus spread when the North briefly reopened its border with China to freight traffic in January and surged further following a military parade and other large-scale events in its capital, Pyongyang, in April.

There are concerns that the threats by Kim’s sister portend a provocation, possibly a nuclear or missile test or even border skirmishes.

Some experts say the North may try to stir up tensions as South Korea and the United States hold their biggest combined military training in years to counter the growing North Korean nuclear threat. The Ulchi Freedom Shield exercise, which involves aircraft, tanks and warships, continues in South Korea through Sept. 1.

Diplomacy between Washington and Pyongyang to defuse the nuclear standoff has stalled since 2019 over disagreements in exchanging crippling U.S.-led sanctions against the North for the North’s denuclearization steps.
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A federal judge on Wednesday blocked Idaho from enforcing an abortion ban when women with pregnancy complications require emergency care, a day after a judge in Texas ruled against President Joe Biden’s administration on the same issue. 

The conflicting rulings came in two of the first lawsuits over the Democratic administration’s attempts to ease abortion access after the conservative majority U.S. Supreme Court in June overturned the 1973 Roe v. Wade decision that legalized the procedure nationwide. 

Legal experts said the two state rulings, if upheld on appeal, could force the Supreme Court to wade back into the debate. 

About half of all U.S. states have or are expected to seek to ban or curtail abortions following Roe’s reversal. Those states include Idaho and Texas, which like 11 others adopted “trigger” laws banning abortion upon such a decision. 

Abortion is already illegal in Texas under a separate, nearly century-old abortion ban that recently took effect after the U.S. Supreme Court’s decision. Idaho’s trigger ban takes effect on Thursday, the same day as those in Texas and Tennessee. 

In Idaho, U.S. District Judge B. Lynn Winmill agreed with the U.S. Justice Department that the abortion ban taking effect Thursday conflicts with a federal law that ensures patients can receive emergency “stabilizing care” at hospitals. 

Threat to patients cited

Winmill, an appointee of former Democratic President Bill Clinton, issued a preliminary injunction blocking Idaho from enforcing its ban to the extent it conflicts with federal law, citing the threat to patients. 

“One cannot imagine the anxiety and fear she will experience if her doctors feel hobbled by an Idaho law that does not allow them to provide the medical care necessary to preserve her health and life,” Winmill wrote. “From that vantage point, the public interest clearly favors the issuance of a preliminary injunction.” 

The Justice Department has said the federal Emergency Medical Treatment and Labor Act requires abortion care in emergency situations. 

Winmill’s decision came after a late-night Tuesday ruling in Texas by U.S. District Judge James Wesley Hendrix holding the U.S. Department of Health and Human Services under Biden went too far by issuing guidance holding the same federal law guaranteed abortion care. 

Hendrix agreed with Texas Attorney General Ken Paxton, a Republican, that the guidance issued in July “discards the requirement to consider the welfare of unborn children when determining how to stabilize a pregnant woman.” 

Hendrix, an appointee of former Republican President Donald Trump, said the federal statute was silent as to what a doctor should do when there is a conflict between the health of the mother and the unborn child and that Texas’s law “fills that void.” 

He issued an injunction barring the federal government from enforcing HHS’s guidance in Texas and against two groups of anti-abortion doctors who also challenged it, saying the Idaho case showed a risk the Biden administration might try to enforce it. 

Hendrix declined, though, to issue a nationwide injunction as Paxton wanted, saying the “circumstances counsel in favor of a tailored, specific injunction.” 

Appellate courts

Appeals are expected in both cases and would be heard by separate appeals courts, one based in San Francisco with a reputation for leaning liberal and another in New Orleans known for conservative rulings. 

Greer Donley, an assistant professor at the University of Pittsburgh Law School and expert on abortion law, said should those appeals courts uphold this week’s dueling rulings, the U.S. Supreme Court may feel pressured to intervene and clarify the law. 

“Without a federal right to abortion, this is the type of legal chaos that most people were predicting would be happening,” she said. 

Shannon Selden, a lawyer at Debevoise & Plimpton who represents several medical associations supporting the Justice Department’s Idaho case, said “there’s a huge cloud over physicians’ ability to provide stabilizing care for patients who need it.” 

“The Justice Department is trying lift that cloud through its Idaho action, and the Texas court has made that cloud darker,” she said.
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Nigeria this week added a rotavirus vaccine to its national program that is expected to prevent 50,000 deaths of children per year from the diarrheal disease. But the launch comes amid shortages of the vaccine in countries such as Cameroon, Kenya, Senegal and Tanzania.

The launch Monday coincided with the commemoration of Africa Vaccination Week.

Officials from the World Health Organization, the United Nations children’s agency, as well as Nigeria’s Health Ministry, attended the launch in the capital.

During the event, many young children received the vaccine for free, while authorities urged citizens to embrace the measure.

“They’ll get the opportunity of taking it when they’re taking other vaccines,” said Faisal Shuaib, executive director of the National Primary Health Care Development Agency. “We need to seize this opportunity — mothers, caregivers — so that our children will be protected from this virus.”

Rotavirus is the most common cause of diarrheal disease in children under 5 years old. WHO says that globally, up to 200,000 children die each year from the disease.

Authorities say the oral vaccine could prevent up to a third of severe diarrhea cases in Nigeria.

WHO country representative Walter Kazadi Mulombo also attended the launch.

“The introduction of the rotavirus vaccine provides the opportunity to reduce the number of children dying every day from diarrheal disease caused by rotavirus,” he said.

But this month, pharmaceutical giant GlaxoSmithKline said manufacturing challenges had led to a shortfall of 4 million doses of the rotavirus this year, as well as delays in delivery.

According to GAVI-the Vaccine Alliance, the company already said it would reduce deliveries of the rotavirus vaccine by 10 million a year between 2022 and 2028.

Moses Njoku, a research fellow at Nigeria’s National Institute for Pharmaceutical Research and Development, said a shortfall should not be a challenge to Nigeria.

“The issue of them thinning out shouldn’t be a threat to a country like Nigeria if we use our internal potential,” Njoku said. “Nigeria is beginning to see the need to start indigenous efforts to start research and production, development of vaccines, as well as production of known vaccines.”

Njoku also said authorities must take delivery of the rotavirus vaccines in batches to avoid waste.

“If care is not taken, they will not be imported at the right time,” he said, adding that some might ship with little time left before an expiration date. “So, eventually you won’t even use up to 10,000 doses and you have paid the money. The supply chain management system is also very poor.”

For now, authorities will be trying to get as many children vaccinated as possible.
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A group of HIV-positive people has been protesting for more than a month at the central office of India’s National AIDS Control Organization, or NACO, in New Delhi, demanding a regular supply of life-saving antiretroviral therapy — also known as ART — drugs across the country.

NACO is the nodal organization of the government of India that manages programs for the prevention and control of HIV and AIDS in the country. ART drugs work by stopping the virus from replicating in HIV-infected people, helping them live longer and reducing or stopping the infection of the virus to others.

Centers that supply ART drugs across India have been out of stock on several antiretroviral drugs for months, threatening the lives and well-being of hundreds of thousands of HIV patients, according to leaders of the group that has been protesting in Delhi since July 21.

“I have been getting distress calls from hundreds of HIV-infected persons from different states of the country reporting the shortage in supply of the ART drugs from the ART centers across the country,” Hari Shankar, a leader of the ongoing Delhi protest, told VOA.

“The crisis has been acute since April. Most of them cannot afford to buy the drugs from the market privately,” Shankar added. “We will not withdraw from this protest until they, all across the country, start receiving the ART drugs supply regularly.”

According to a government estimate, India has 2.3 million people living with HIV. In 2004, the government began providing free ART to the people living with HIV in the country. Now around 1.5 million HIV patients are dependent on the ART provided by the government.

NACO procures ART drugs and distributes them through more than 675 ART centers spread across the country. People undergoing ART visit the centers every one, two or three months to collect their drugs. But since April, the supply of the drugs has been irregular in many parts of the country, many people said.

“Earlier, we regularly used to get the stock of the drugs for one to three months. Now we get the drugs just for one week or 10 days. The ART centers even in some big hospitals in New Delhi are turning us away because of the shortage of the drugs,” said Shankar, a member of the Delhi Network of Positive People or DNP Plus, which works to facilitate better medical treatment for people living with HIV/AIDS in New Delhi.

The Delhi protest demanding a regular supply of ART drugs across the country is organized by DNP Plus.

Nisha Jha, another DNP Plus member, said that many people across the country are reporting a shortage of Dolutegravir (DTG) 50 mg, a key ART drug, from the ART centers.

“Those HIV patients who have been on the first line, second line, or third line ART for years, and are also infected with tuberculosis, need to take DTG 50 separately,” Jha told VOA.

“Because of the crisis of DTG, lives of thousands of our PLHIV brothers and sisters are in jeopardy now.”

There is a crisis of drugs like Nevirapine, Ritonavir, Lopinavir, Abacavir, and Zidovudine — which are used in different ART regimens for HIV ­patients — at ART centers across the country, Jha added.

The ART centers are asking patients to change their drug regimens because of the shortages of some drugs, many people said.

Surmick Waribam, a leader of HIV patients group Manipur Network of Positive People, or MNP Plus, in the northeastern state of Manipur, said the normal protocol calls for HIV patients to undergo certain medical tests before their ART regimens are changed.

“The ART centers are asking HIV patients to change the regimens without conducting any such medical tests. The patients are scared to change the regimen, fearing adverse impacts on their health. Being very poor, most of them cannot afford to buy the drugs from the market. So, they are left with no option but to change the regimen,” Waribam told VOA.

In response to a query from VOA, Dr. Manisha Verma, a spokesperson for the Indian health ministry, said in an emailed statement that there is “adequate stock for around 95% [of HIV patients] in India.”

“There is no stock-out of drugs and there are no instances of disruptions or non-availability of treatment services or ARV medicines at the national and state levels,” Verma said.

Dr. Mothi SN, an HIV and AIDS specialist, said that since the global roll-out of ARV medicines began in 2004, the HIV/AIDS scenario changed from being a “rapidly progressing fatal illness” to that of “a chronic manageable illness like diabetes or hypertension with a near-normal life expectancy.”

“Regular intake of ARV medicines and prompt adherence to treatment are resulting in added years of life. People with HIV may survive the infection and finally die of other age-related diseases like stroke, heart disease, cancer, etc.,” Mysore-based Mothi told VOA.

“To achieve the optimum outcome, prompt adherence to uninterrupted ARV therapy becomes the cornerstone of management of people living with AIDS.”

Waribam from Manipur said the shortage in supply of his regular ARV drugs forced him to switch to a new regimen of drugs.

“For my ARV drugs, I am dependent solely on the ART center. So, in June, like most of around 14,000 [people living with HIV] in Manipur, I agreed to switch to the new drugs the ART center offered. Even then, the ART centers are giving us drugs for three, five or 10 days,” Waribam said.

“Like thousands of others, I am also anxious and in doubt, if the new drugs would succeed to keep my viral load under check and not cause any damage to my health. …The authorities are playing with the lives of the PLHIV.”
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An Ebola vaccination campaign will start in the Congolose city of Beni on Thursday after a new case of the virus was confirmed this week, the World Health Organization said on Wednesday.

More than 200 vaccine doses have been arrived in Beni, in the east of Democratic Republic of Congo, it said.

The latest confirmed case has been genetically linked to a 2018-2020 outbreak in North Kivu and Ituri provinces, which claimed nearly 2,300 lives.

Six people were killed in another flare-up from that same outbreak last year.

A WHO spokesman told Reuters the shots were provided by the organization and that inoculations would start on Thursday.

Congo’s dense tropical forests are a natural reservoir for the Ebola virus, which causes fever, body aches, and diarrhea, and can linger in the body of survivors only to resurface years later.

The vast central African country has recorded 14 outbreaks since 1976. The 2018-2020 outbreak in the east was Congo’s largest and the second largest ever recorded, with nearly 3,500 total cases.

Congo’s most recent outbreak was in northwest Equateur province. Itwas declared over in July after five deaths.
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Scorching temperatures across the globe this year have people wondering if climate change is making some places too hot to live in.
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Switzerland’s 1,400 glaciers have lost more than half their total volume since the early 1930s, a new study has found, and researchers say the ice retreat is accelerating at a time of growing concerns about climate change.

ETH Zurich, a respected federal polytechnic university, and the Swiss Federal Institute on Forest, Snow and Landscape Research on Monday announced the findings from a first-ever reconstruction of ice loss in Switzerland in the 20th century, based in part on an analysis of changes to the topography of glaciers since 1931.

The researchers estimated that ice volumes on the glaciers had shrunk by half over the subsequent 85 years — until 2016. Since then, the glaciers have lost an additional 12%, over just six years.

“Glacier retreat is accelerating. Closely observing this phenomenon and quantifying its historical dimensions is important because it allows us to infer the glaciers’ responses to a changing climate,” said Daniel Farinotti, a co-author of the study, which was published in scientific journal The Cryosphere.

By area, Switzerland’s glaciers amount to about half of all the total glaciers in the European Alps.

The teams drew on a combination of long-term observations of glaciers. That included measurements in the field and aerial and mountaintop photographs — including 22,000 taken from peaks between the two world wars. By using multiple sources, the researchers could fill in gaps. Only a few of Switzerland’s glaciers have been studied regularly over the years.

The research involved using decades-old techniques to allow for comparisons of the shape and position of images of terrain, and the use of cameras and instruments to measure angles of land areas. The teams compared surface topography of glaciers at different moments, allowing for calculations about the evolution in ice volumes.

Not all Swiss glaciers have been losing ice at the same rates, the researchers said. Altitude, amounts of debris on the glaciers, and the flatness of a glacier’s “snout” — its lowest part, which is the most vulnerable to melting — all affect the speeds of ice retreat.

The researchers also found that two periods — in the 1920s and the 1980s — actually experienced sporadic growth in glacier mass, but that was overshadowed by the broader trend of decline.

The findings could have broad implications for Switzerland’s long-term energy sources, since hydropower produces nearly 60% of the country’s electricity, according to government data.
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British health authorities will begin offering eligible people just a fraction of the normal monkeypox vaccine dose to stretch supplies by about five times, in line with similar decisions to extend available doses in Europe and the U.S.

In a statement Monday, Britain’s Health Security Agency said patients at clinics in Manchester and London would soon get just one fifth the regular monkeypox vaccine dose as part of ongoing research, citing earlier work suggesting the smaller dose provided as effective an immune response as a full dose.

Last week, the European Medicines Agency authorized the move for its 27 members across the continent, echoing the decision made by U.S. regulators earlier this month.

“Adopting this tried and tested technique will help to maximize the reach of our remaining stock,” said Dr. Mary Ramsay, head of immunization at Britain’s Health Security Agency. She said the lowered doses would enable health workers to vaccinate “many more thousands of people.”

Last week, British officials said there were early signs the monkeypox outbreak is slowing and that case numbers are declining. Nearly 3,200 cases have been reported in the U.K. since May, with 99% of infections among men who are gay, bisexual or have sex with other men. About 70% of cases are in London.

As of last week, U.K. authorities said more than 35,000 vaccines had been administered primarily to men who have sex with men, their close contacts, and health workers.

Globally, the supply of monkeypox vaccines is extremely limited. There is only one supplier — Denmark’s Bavarian Nordic —and most doses have already been bought by the U.S., Canada, Europe and other rich countries.

Bavarian Nordic estimated its production capacity for this year was about 30 million doses. No monkeypox vaccines have so far been allotted to Africa, which has reported more than 70 suspected deaths, the highest number anywhere.

To date, more than 41,000 cases of monkeypox have appeared worldwide in 94 countries. The World Health Organization and other health agencies do not recommend mass vaccination, but have advised countries to improve their monkeypox surveillance, testing and encouraged other measures to slow the disease’s spread.

WHO has recommended that men at high risk of the disease temporarily consider reducing their number of sex partners or refrain from group or anonymous sex.
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