Overview of research actions to combat mpox
Mpox is an infectious disease caused by the monkeypox virus. There are 2 different clades of the virus: clade I (with subclades Ia and Ib) and clade II (with subclades IIa and IIb), which circulate in different geographic areas and affect different populations.
Historically, mpox virus infection was limited to certain African regions, but it emerged as a global concern in 2022 when mpox cases were reported worldwide in non-endemic countries, including in 29 EU/EEA countries. This outbreak was declared a public health emergency of international concern by the World Health Organisation (WHO) in July 2022, which it declared to be ended in May 2023. However, an unprecedented increase in the number of countries reporting mpox cases and outbreaks in the WHO African Region led to a new WHO declaration of a public health emergency of international concern on 14 August 2024.
In response to the mpox outbreak in 2022, the EU mobilised €17 million of emergency funding under Horizon Europe to support the implementation of European clinical research initiatives on mpox. This funding capitalised on the networks that had been established during the COVID-19 pandemic response to enhance Europe’s preparedness and response.
2 projects received funding from this emergency response funding: MPX-RESPONSE and VERDI.
MPX-RESPONSE project
The MPX-RESPONSE project aims to increase the knowledge of mpox, to evaluate potential treatments, and to allow the European Union and the international community to respond to public health emergencies. This project includes one observational study to improve our understanding of clinical and virological outcomes in patients with mpox disease, and three randomised control trials to generate evidence on treatment efficacy and safety in EU, Latin America, and Africa. This project has received an EU contribution of €12 million.
VERDI project
The VERDI project had already started in 2021 with a focus on better understanding COVID-19 in children and pregnant women using observational studies from the EU and beyond. Its activities were expanded following the mpox outbreak of 2022, to better track, characterise and understand mpox disease. This project is working to describe the clinical features, treatments, and risk factors for severe disease in children and adults with mpox infection (including pregnant women). VERDI has received an EU contribution of €15 million, of which €5 million is dedicated to mpox and preparedness activities.
VEO project
The Horizon 2020 project VEO has established a versatile observatory for the prediction, detection and tracking of emerging infectious diseases. VEO has contributed to generate evidence to investigate the mpox outbreak in the EU in 2022 by enhancing our understanding of the epidemiology and evolution of monkeypox virus. Crucially, VEO has released the first genomic sequence data from the DRC mpox 2023 outbreak of clade I. The project has helped to identify and understand this clade of the virus and to gain assurance that current and commonly used molecular assays to diagnose monkeypox virus infections can detect these strains. VEO has received an EU contribution of €18 million.
The Global Health EDCTP3 Emergency call for response
The Global Health EDCTP3 is the African and European clinical research partnership, which was established in 2004 and is currently in its third iteration. It has a budget of €1.86 billion with €910 million coming from Horizon Europe, at least €550 million from the participating countries in Africa and Europe, and €400 million from other contributing partners (other funders, philanthropies, industry).
Global Health EDCTP3 launched an emergency call for mpox response in Democratic Republic of Congo (DRC) on 30 April 2024, in light of rising numbers of cases being reported in DRC and the high public health risk. At present, 5 projects in DRC are funded for a total of €6.7 million. These projects address surveillance, better understanding of the virus and its transmission, and vaccine trials on safety and immunogenicity in mothers and infants. The projects are run by collaborative research consortia from Africa and Europe. It is expected that 40% of the funding will go to entities based in the DRC itself.
These projects started on 1 August 2024, two weeks before the WHO declared Mpox a Public Health Emergency of International Concern and will provide vital information to the DRC and its neighbouring countries, the Africa CDC, the WHO, and to the EU as well. Moreover, additional funding has been secured to fund another four research projects currently under negotiation.
Pandemic preparedness partnership
A European partnership for pandemic preparedness is under development to improve EU’s preparedness to predict and respond to emerging infectious health threats. The partnership will ensure better coordination of funding for research and innovation in the EU (and contributing globally), towards common objectives.
The partnership will promote coordination and prioritisation of a comprehensive research response to a health emergency, from basic research for better understanding of pathogens with pandemic potential to the development or adaptation of medical countermeasures, as well as effective non-pharmaceutical interventions and/or public health and social measures.
Preparatory work on the Pandemic Preparedness Partnership is being done via the BE READY coordination and support action, funded under Horizon Europe. BE READY started its work in September 2022 and brings together 13 EU countries, Norway, Switzerland and the United Kingdom.
