US response to monkeypox brings activists to troubling memories of the AIDS era

“The reason people feel the parallels so keenly now is because of the rise in anti-LGBTQ sentiment that also preceded HIV,” said Frans, now a director whose work includes Oscar-nominated How to Survive the Plague. documentary on the AIDS response.

He and other supporters are increasingly criticizing the Biden administration and the medical community around the world for being too slow in testing and vaccinating against monkeypox, and for failing to clearly communicate the risks of the disease to the community it has overwhelmingly affected: men who have sex. c humans The first confirmed case of monkeypox in the US this year was reported on May 18; there are currently over 6,320 throughout the country and the number is expected to increase significantly.

“I’m incredibly angry that we let this spread this far and that the federal government couldn’t come together to figure out how to ramp up testing quickly, figure out how to do active surveillance to make sure vaccines and treatments were here when they were. were needed,” said Gregg Gonsalves, a global health activist and epidemiologist at Yale University.

The administration seems to be finally listening to these concerns. On Tuesday, in an effort to improve the response and sharpening criticism, President Joe Biden named top officials from the Federal Emergency Management Agency and the Centers for Disease Control and Prevention to lead the national response to monkeypox.

Robert Fenton, a longtime FEMA employee, won the White House’s trust during the Covid vaccine rollout for his help in maintaining a network of Covid vaccine center administrations. He is expected to manage logistics at the response center, including efforts to expedite the distribution of tests and vaccines. Demeter Daskalakis, who will serve as Fenton’s deputy, has helped lead the CDC’s work on HIV/AIDS and is well known for his work in engaging the LGBTQ community in public health issues – an experience that will likely help the administration in its quest to slow transmission in the most dire of conditions. – affected areas.

The question is whether such steps are too late.

Until recently, the White House has largely left the leadership of the monkeypox response to the Department of Health. But department officials have struggled to coordinate the burgeoning effort, leading to shortages of vaccines and tests and harsh criticism from activists and health experts. The response continues to be hampered by the difficulty of gathering data from individual states, allowing cases to spread across the country virtually unnoticed.

Gonçalves noted the lack of a strong and convincing response from governments around the world, which he said should have been better prepared in the wake of AIDS and especially the Covid-19 pandemic. In particular, he argued that the US government was once again taken by surprise. He blamed “our crappy public health and pandemic preparedness in general, but this kind of wishful thinking from the White House is just amazing.”

While there is a vaccine for monkeypox, unlike AIDS, the disease is spreading fast enough to make survivors of that past crisis draw parallels to the current one. Chief among them is a growing sense among activists that, decades later, public health officials are making mistakes that could make LGBT people feel left out again.

“They had tools this time, right?” France said. “They had the vaccines and they had a connection to the community they could communicate prevention to.”

But there are obvious flaws in the parallel, as Biden administration officials are quick to point out. And it’s not just that no one in the United States has died of monkeypox. The attitude of the White House towards the affected community is also very different.

The Biden administration is taking the current outbreak seriously, said Harold Phillips, director of the White House Office of National AIDS Policy. He noted that during the Reagan administration, press secretary joke about AIDS with journalists during briefings.

“There are some similarities between the community affected by this disease. Pain, suffering, fear of stigmatization, but this time the White House was not laughing,” Phillips said.

After the first confirmed case of monkeypox in the US was identified in May, the Biden administration ordered 36,000 doses of vaccines within two days and 300,000 doses over the next month, White House aides said. Despite initial deliveries, shortages persist, especially in the hardest-hit cities. Last week, states of emergency were declared in California, Illinois, and New York due to the spread of the disease.

“Public health in our country is underfunded and also fragmented,” Phillips said, noting that the current outbreak comes amid an ongoing pandemic and increasingly dangerous variants of Covid.

“We all said during Covid that we need to be ready for the next one. And I don’t think we expected it to happen as soon or as quickly as it did,” he said.

The decision to add federal coordinators to lead the response was met with cautious optimism by some supporters. But even health officials and experts admit there is little they can do at the moment to stop the spread of monkeypox until more vaccines are available. Only 2 million shots of the two-dose vaccine are expected to be available in the US by the end of the year, leading to projections of long-term shortages.

Meanwhile, the monkeypox outbreak was growing exponentially, the number of cases doubling every week. Health experts fear that if transmission does not slow soon, the country will lose all hope of containing the disease, allowing it to take hold as a vague threat.

France said the increase in vaccines alone would not be effective unless the administration also better coordinated its messages to the affected community. Perhaps there will be more treatments available and more empathy for the sick than during the AIDS epidemic. But without constructive communication, it won’t work out as planned.

“Those of us who, like me, faced the HIV epidemic during the years of the plague, 15 years before there was any effective treatment, we learned to behave in a safe and effective way,” Frans said. “Here’s the message. Here’s the solution. Get them both out at once. Then everyone knows what they need to do, and they do it. And now that message isn’t there. Nobody knows where those vaccines are, whether they’ll arrive at all, whether the second dose will arrive.” .There, there is no one.