Here Are The Companies That Could Profit As Governments Scramble To Secure Monkeypox Treatments And Vaccines

Topline

Outbreaks across Europe and North America of monkeypox—a rare virus not normally found outside parts of Africa— have governments spooked and scrambling to secure supplies of treatments and vaccines to contain the disease.

Experts are unsure how long monkeypox has been spreading outside the regions of Africa it is usually … [+] found.

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Key Facts

Bavarian Nordic, a Danish biotech that manufactures the only authorized vaccine against monkeypox in the world, has been “bombarded” with acquisition requests—including from countries that have not reported monkeypox cases, spokesman Rolf Sass Sørensen told Forbes.

Sørensen said the firm is confident it will be able to meet demand for the shot, known by brand name Jynneos in the U.S., and can produce around 30 million doses a year.

U.S. drugmaker Emergent BioSolutions produces smallpox vaccine ACAM2000 and two smallpox treatments that, while not authorized for monkeypox, can be deployed to tackle outbreaks due to similarities between the two viruses.

Emergent told Forbes it has the capacity to produce around 18 million doses of ACAM2000 a year—there are over 100 million doses in the national stockpile—and has had more interest in its products since the outbreak, though it would not discuss specifics or whether it was going to expand or accelerate production.

Emergent also makes Vaccinia Immune Globulin—an antibody therapy which is not proven against monkeypox but can be used as an investigational drug in serious cases—and recently inked a $337.5 million deal with biopharmaceutical firm Chimerix for the antiviral drug brincidofovir.

Emergent told Forbes the acquisition of the antiviral—which the FDA approved for use against smallpox in 2021 and is also known as Tembexa—has not yet closed and Chimerix did not respond to Forbes’ requests for comment.

Siga Technologies’ antiviral drug tecovirimat, branded as TPOXX, is only approved to treat smallpox in the U.S., but the European Medicines Agency has authorized it for use against monkeypox and cowpox.

Dennis Hruby, Siga’s chief scientific officer, told Forbes there are 1.7 million courses of the drug in the U.S. government stockpile and said there have been lots of requests for the drug in Europe and other countries as the outbreak unfolds, adding that the company is ready to “ramp up” production and set up a secondary supply chain if demand grows.

Moderna, the Massachusetts-based biotech behind one of the most successful Covid-19 vaccines, said it was in the early stages of “investigating potential monkeypox vaccines.”

Key Background

Unlike the virus that causes Covid-19, monkeypox is a well-known entity that has been circulating in parts of Central and Western Africa for decades. The disease is typically mild and goes away on its own within a month or so, with symptoms that include fever and a rash that can resemble syphilis or chickenpox. Monkeypox can be lethal, however, with documented fatality rates varying between around 1% and 10% depending on which of two different strains of the virus circulating that a person is infected with. Infection is more dangerous for children and can cause complications during pregnancy. Monkeypox is closely related to smallpox—one of history’s worst killers and the only human disease to have been eradicated—meaning treatments and vaccines developed for smallpox are often very effective against monkeypox, too. “In theory, we should be very well prepared to manage an outbreak,” Matthew Aliota, a virologist at the University of Minnesota, told Forbes. Though hoped to be extinct in the wild, the U.S. government maintains a strategic stockpile of drugs and vaccines for use against smallpox in case the virus somehow returns or is used as a weapon. A Department of Health and Human Services spokesperson told Forbes the federal government holds “enough smallpox vaccine to vaccinate the entire U.S. population” in the event of a smallpox or monkeypox emergency. The stockpile also contains antiviral drugs to treat smallpox infections, which the spokesperson said are not approved to treat monkeypox but could be “used in certain circumstances.”

What To Watch For

Monkeypox spreading to animals. Monkeypox is a zoonotic disease, meaning it moves from animal reservoirs into humans. Despite the name—the virus was first identified in laboratory monkeys in the 1950s—the animal reservoir for monkeypox is not known. Experts believe rodents are the most likely animal to harbor the virus in Africa. In 2003, there was an outbreak in the U.S. linked to prairie dogs that experts believe were infected by giant rats imported from Ghana. Aliota, who studies zoonotic viruses, told Forbes there is a “real risk” monkeypox could establish itself in new wild animal reservoirs in places like the U.K. and U.S., a concern the European Center for Disease Prevention and Control has already flagged. Rodents and squirrels are the most likely animals to harbor the virus given the suspected reservoirs in Africa, Aliota said, adding that the best way to stop this happening is to eliminate the spread in humans.

What We Don’t Know

Why we are seeing this outbreak. Monkeypox does not spread easily between humans and cases outside of endemic areas are rare. Those that do crop up elsewhere are generally linked to travel in the endemic regions. The geographic spread and scale of this outbreak “is unusual,” Ellen Carlin, a professor at Georgetown University’s Center for Global Health Science and Security, told Forbes. Carlin said there are several key bits of information experts are trying to figure out about the outbreak, including how the virus is spreading, how long it has been spreading and whether the cases are all connected. “Figuring out the specific exposures and routes of spread is key.”

Tangent

The monkeypox outbreak has kicked off a flurry of interest in diagnostic kits to test for the rare disease, whose makers include Chinese firms Jiangsu Bioperfectus, Daan Gene and Sansure Biotech. U.S. Abbott Laboratories and Swiss pharma giant Roche also announced they are developing monkeypox tests. A Roche spokesperson told Forbes their tests are only available for research use in the U.S. at the moment and don’t yet have FDA clearance, though the company is “working through the regulatory and logistical [steps]… to get this into customers hands.” While they said they could not disclose details on interest for the tests, the spokesperson told Forbes the company is “confident about meeting needs” and doesn’t anticipate any “supply issues.”