Public health, LGBTQ advocacy groups say nation remains unprepared for next outbreak

A coalition of leading public health organizations on Tuesday praised the administration’s response to the mpox outbreak but raised red flags about the nation’s continued “lack of readiness” to swiftly respond to health threats or emergencies.

In a letter to President Biden sent as the Department of Health and Human Services (HHS) public health emergency for the disease expires, the National Mpox Working Group outlined the administration’s successes and shortcomings in its handling of the mpox outbreak and offered recommendations to build a more robust public health system capable of responding to emergencies.

More than 30,000 cases of mpox — the disease formerly known as monkeypox — have been reported nationwide since May, when the first known case was cataloged in the U.S., according to the Centers for Disease Control and Prevention (CDC).

The National Mpox Working Group since its inception in June has worked to inform policy decisions made by the White House and Congress pertaining to the outbreak.

The working group in its Tuesday letter commended the Biden administration for bolstering interagency collaboration and communication to successfully contain the spread of mpox, but added that the message was sent primarily to “express our concern regarding the nation’s preparedness for future infectious disease outbreaks.”

“Mpox was the first national novel infectious disease to test many of the systems put in place during the COVID-19 pandemic, and it offers a roadmap to prepare for the next outbreak,” said the letter from the working group, a partnership of roughly two dozen public health, medical and LGBTQ advocacy organizations including AIDS United and the National Center for Lesbian Rights.

Among other preventative measures, the administration should prioritize public health interventions that resolve racial and geographic health inequities at the outset of emergencies, “rather than addressing them after they have already occurred or become entrenched.”

Multiple inquiries into the spread of mpox in the U.S. have found stark disparities in infection rates among Black and Hispanic Americans, who have accounted for a disproportionate share of cases relative to their share of the population.

CDC report published earlier this month found that among mpox cases reported among cisgender women, Black and Hispanic women were disproportionately represented. Overall, the outbreak has overwhelmingly affected men who have sex with men.

The National Mpox Working Group on Tuesday also stressed the need for a federal financial support plan that includes increased investment in the nation’s public health system.

“Anything less sets a disturbing precedent for what we can expect in the next public health crisis,” the coalition wrote. More federal funding should also be diverted to community-based programs like local STI clinics — many of which burned through their own budgets to test, treat and vaccinate their communities against mpox, the letter said.

“Too many people suffered unnecessarily and the front-line organizations that responded to this outbreak exhausted their own limited funds to provide information, health care and support to their communities – only to see the White House reduce its critical needs request to Congress,” the groups wrote. 

“This lack of support on behalf of America’s public health system undercut the very real needs of those in the field at a time when capacity and resources were stretched to the brink. We are disappointed that they did not get the timely, forceful, and tangible White House support they needed.”