The UK government has procured 150,000 doses of additional mpox vaccine in preparation for anticipated cases of a new potentially deadlier strain causing a growing outbreak in Africa and isolated cases in Europe and Asia detected in recent weeks.
The UK has yet to identify a case of the Clade 1b strain of mpox, and health officials say the risk to the UK remains “low”.
Despite precautions at UK borders, the long incubation time of mpox and likely global spread mean health officials are preparing for its arrival.
In addition to purchasing more doses of mpox vaccine, on Monday the UK Health Security Agency (UKHSA) published its risk assessment for Clade 1b, including scenarios for a UK outbreak.
“Alongside vaccination, we have been working rapidly to ensure that clinicians are aware and able to recognise cases promptly, that rapid testing is available, and that protocols are developed for the safe clinical care of people who have the infection and the prevention of onward transmission,” said Professor Susan Hopkins, chief medical adviser at the UKHSA.
The risk assessment is based largely on the ongoing outbreak of Clade 2 mpox that has led to more than 100,000 cases worldwide and nearly 4,000 in the UK.
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1:53
Last month: Mpox – what is the risk?
That strain of the virus has been confined largely to gay and bisexual men and a vaccine campaign centred around sexual health clinics that began in 2022 has been successful in reducing levels of transmission in the UK.
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The Clade 1b outbreak in Africa has different features that make the virus of concern. It has been spreading among heterosexual partners – largely among sex workers – but also causing outbreaks within families and among children.
Image: The Democratic Republic of Congo has seen a recent upsurge in cases. File pic: Reuters
Based on available data less than 1% of cases are fatal.
However with so few cases outside of Africa, there is little information to assess whether it is more infectious or more dangerous.
The first UK outbreak scenario assumes the Clade 1b strain is less infectious than the Clade 2 strain of mpox and results in “incursions and small clusters” of cases. In this case, any outbreak would be largely self-contained and contact tracing and isolation of infected cases would be sufficient to contain it.
Image: Mpox virus under a microscope. Pic: NIAID/Reuters
‘Controllable epidemic’ is possible
The second scenario assumes Clade 1b is as infectious as the Clade 2 strain and would result in a “controllable epidemic”. In these circumstances, it is assumed that by the time it is detected in the UK, there would already be “established chains of transmission” among sexual networks.
Targeted vaccination of “high-risk” individuals including men who have sex with men, sex workers and at risk clinical staff is expected to be sufficient to bring the outbreak under control. “Ring vaccination” of contacts of infected individuals would be used to limit “breakthrough” infections within families including young children.
The third scenario assumes Clade 1b is more infectious than Clade 2. While, according to the risk assessment this should not be discounted, there is “considerable uncertainty on whether it is possible for mpox to be more transmissible”.
Not enough jabs for whole of UK
In this case, the virus spreads via physical contact and would lead to multiple outbreaks in households and other “close-contact” settings such as nurseries, care homes hospitals and prisons.
Steps such as contact tracing or quarantine would not be effective in controlling an outbreak in this scenario – only a UK-wide vaccination programme. Currently, global stocks of the mpox vaccine would be insufficient to allow this.
Hopefully, it would never come to that. Officials estimate that the most likely outcome for Clade 1b mpox is somewhere between the first and second scenarios.
For the time being, the UK has ordered what it believes to be sufficient vaccine to tackle the expected outbreak. A calculation also based on the fact the best way of protecting ourselves is to ensure there is sufficient global supply to ensure it is available in Africa – the current epicentre.
“Across government, we are closely monitoring the spread of this virus overseas and are proud to be at the forefront of the international response, including through our early support to the Democratic Republic of Congo,” said Health Secretary Wes Streeting.
Russia wants “quick peace” in Ukraine and London is at the “head of those resisting” it, the Russian ambassador to the UK has told Sky News.
In an interview on The World With Yalda Hakim, Andrei Kelin accused the UK, France and other European nations of not wanting to end the war in Ukraine.
“We are prepared to negotiate and to talk,” he said. “We have our position. If we can strike a negotiated settlement… we need a very serious approach to that and a very serious agreement about all of that – and about security in Europe.”
Image: Russian ambassador Andrei Kelin speaks to Yalda Hakim
US President Donald Trump held a surprise phone call with his Russian counterpart Vladimir Putin last month, shocking America’s European allies. He went on to call Ukrainian President Volodymyr Zelenskyy a “dictator” and relations between the pair were left in tatters after a meeting in the Oval Office descended into a shouting match.
Days later, the US leader suspended military aid to Ukraine, though there were signs the relationship between the two leaders appeared to be on the mend following the contentious White House meeting last week, with Mr Trump saying he “appreciated” a letter from Mr Zelenskyy saying Kyiv was ready to sign a minerals agreement with Washington “at any time”.
In his interview with Sky News’ Yalda Hakim, Mr Kelin said he was “not surprised” the US has changed its position on Russia’s full-scale invasion of Ukraine, which began in 2022, claiming Mr Trump “knows the history of the conflict”.
“He knows history and is very different from European leaders,” he added.
I’ve interviewed the Russian ambassador to the UK, Andrei Kelin, on a number of occasions, at times the conversation has been tense and heated.
But today, I found a diplomat full of confidence and cautiously optimistic.
The optics of course have suddenly changed in Russia’s favour since Donald Trump was elected.
I asked him if Russia couldn’t believe its luck. “I would not exaggerate this too much,” he quipped.
Mr Kelin also “categorically” ruled out European troops on the ground and said the flurry of diplomatic activity and summits over the course of the past few weeks is not because Europeans want to talk to Moscow but because they want to present something to Mr Trump.
He appeared to relish the split the world is witnessing in transatlantic relations.
Of course the ambassador remained cagey about the conversations that have taken place between President Trump and Vladimir Putin.
There is no doubt however that Russia is welcoming what Mr Kelin says is a shift in the world order.
Peace deal ‘should recognise Russian advances’
The Russian ambassador said Moscow had told Washington it believed its territorial advances in Ukraine “should be recognised” as part of any peace deal.
“What we will need is a new Ukraine as a neutral, non-nuclear state,” he said. “The territorial situation should be recognised. These territories have been included in our constitution and we will continue to push that all forces of the Ukrainian government will leave these territories.”
Asked if he thought the Americans would agree to give occupied Ukrainian land to Russia, he said: “I don’t think we have discussed it seriously. [From] what I have read, the Americans actually understand the reality.”
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31:20
In full: Russian ambassador’s interview with Sky’s Yalda Hakim
Moscow rules out NATO peacekeepers in Ukraine
He said Russia “categorically ruled out” the prospect of NATO peacekeepers on the ground in Ukraine – a proposal made by UK Prime Minister Sir Keir Starmer and French President Emmanuel Macron – saying “they have no rules of engagement” and so would just be “sitting in cities”.
“It’s senseless” and “not for reality,” Mr Kelin added.
He branded the temporary ceasefire raised by Mr Zelenskyy “a crazy idea”, and said: “We will never accept it and they perfectly are aware of that.
“We will only accept the final version, when we are going to sign it. Until then things are very shaky.”
He added: “We’re trying to find a resolution on the battlefield, until the US administration suggest something constructive.”
The United States is “finally destroying” the international rules-based order by trying to meet Russia “halfway”, Ukraine’s ambassador to the UK has warned.
Valerii Zaluzhnyi said Washington’s recent actions in relation to Moscow could lead to the collapse of NATO– with Europe becoming Russian President Vladimir Putin‘s next target.
“The failure to qualify actions of Russiaas an aggression is a huge challenge for the entire world and Europe, in particular,” he told a conference at the Chatham House think tank.
“We see that it is not just the axis of evil and Russia trying to revise the world order, but the US is finally destroying this order.”
Image: Valerii Zaluzhnyi. Pic: Reuters
Mr Zaluzhnyi, who took over as Kyiv’s ambassador to London in 2024 following three years as commander-in-chief of the Ukrainian armed forces, also warned that the White House had “questioned the unity of the whole Western world” – suggesting NATO could cease to exist as a result.
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But on the same day, the US president ordered a sudden freeze on shipments of US military aid to Ukraine,and Washington has since paused intelligence sharing with Kyiv and halted cyber operations against Russia.
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Mr Zaluzhnyi said the pause in cyber operations and an earlier decision by the US to oppose a UN resolution condemning Russian aggression in Ukraine were “a huge challenge for the entire world”.
He added that talks between the US and Russia – “headed by a war criminal” – showed the White House “makes steps towards the Kremlin, trying to meet them halfway”, warning Moscow’s next target “could be Europe”.
The Rohingya refugees didn’t escape danger though.
Right now, violence is at its worst levels in the camps since 2017 and Rohingya people face a particularly cruel new threat – they’re being forced back to fight for the same Myanmar military accused of trying to wipe out their people.
Image: A child at the refugee camp in Cox’s Bazar
Militant groups are recruiting Rohingya men in the camps, some at gunpoint, and taking them back to Myanmar to fight for a force that’s losing ground.
More on Rohingyas
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Jaker is just 19.
We’ve changed his name to protect his identity.
He says he was abducted at gunpoint last year by a group of nine men in Cox’s.
They tied his hands with rope he says and took him to the border where he was taken by boat with three other men to fight for the Myanmar military.
“It was heartbreaking,” he told me. “They targeted poor children. The children of wealthy families only avoided it by paying money.”
And he says the impact has been deadly.
“Many of our Rohingya boys, who were taken by force from the camps, were killed in battle.”
Image: Jaker speaks to Sky’s Cordelia Lynch
Image: An aerial view of the refugee camp in Cox’s Bazar
The situation in Cox’s is desperate.
People are disillusioned by poverty, violence and the plight of their own people and the civil war they ran from is getting worse.
In Rakhine, just across the border, there’s been a big shift in dynamics.
The Arakan Army (AA), an ethnic armed group has all but taken control of the state from the ruling military junta.
Both the military and the AA are accused of committing atrocities against Rohingya Muslims.
And whilst some Rohingya claim they’re being forced into the fray – dragged back to Myanmar from Bangladesh, others are willing to go.