US response to monkeypox brings back anxious AIDS-era memories for activists

One “reason why people feel the parallels so intensely now is because of the rise of anti-LGBTQ sentiment, which also predated HIV,” said France, now a filmmaker whose work includes “How to Survive a Plague.” , an Oscar-nominated film. documentary on the AIDS response.

He and other advocates have increasingly criticized the Biden administration and the health community worldwide, for moving too slowly on monkeypox testing and vaccines, and for not being clear communicated the risks of the disease to the community it massively affected: men who have sex with but This year, the first confirmed US case of monkeypox was recorded on May 18; there are now more than 6,320 across the country – a number that is expected to grow significantly.

“I’m angry beyond belief that we let it spread this far, and that the feds couldn’t pull themselves together to figure out how to ramp up testing quickly, to figure out how to do active surveillance to making sure vaccines and treatments were there when they were needed,” said Gregg Gonsalves, global health campaigner and epidemiologist at Yale University.

The administration finally seems to hear these concerns. On Tuesday, in an effort to improve the response and the harsh criticism, President Joe Biden appointed 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 official, won the White House’s trust during the Covid vaccine rollout for his help in setting up the administration’s network of Covid vaccine sites. He should manage logistics at the center of the response, including efforts to speed up the distribution of tests and vaccines. Demetre 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 engaging the LGBTQ community on public health issues — expertise likely to guide the attempt to administration to slow down transmission in the most difficult – affected areas.

The question is whether such moves came too late.

Until recent weeks, the White House had largely left it to the health department to lead the response to monkeypox. But department leadership has struggled to coordinate the sprawling effort, leading to vaccine and testing shortages and intense criticism from activists and health experts. The response continues to be hampered by difficulties in collecting data from individual states, allowing cases to spread across the country largely unseen.

Gonsalves noted that there was a lack of proactive and convincing response from governments around the world, which he said should have been better prepared after AIDS and in particular the Covid-19 pandemic. The US government in particular, I was saying, was again caught off guard. He blamed “our shit on public health and pandemic preparedness in general, but the kind of wishful thinking from the White House is just astounding.”

While monkeypox, unlike AIDS, has a vaccine, the disease spreads fast enough to compel people who have lived through this past crisis to see parallels with this one. Foremost among them is a growing sense among activists that, decades later, public health officials are making missteps that could once again leave LGBTQ people feeling like an afterthought.

“This time they had the tools, didn’t they?” says France. “They had the vaccines and they had a connection to the community, which they could send on prevention.”

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

The Biden administration takes the current epidemic seriously, said Harold Phillips, director of the Office of National AIDS Policy at the White House. I noticed under the Reagan administration, the press secretary joked about aids with journalists during press briefings.

“There are some similarities between the community that is affected by this disease. The pain, the suffering, the fear of stigma, but it was no laughing matter this time in the White House,” Phillips said.

After the first confirmed U.S. case of monkeypox was identified in May, the Biden administration ordered 36,000 vaccine doses in two days and 300,000 doses the following month, White House aides said. Despite initial shipments, shortages persisted, especially in the hardest-hit cities. Over the past week, states of emergency have been declared in California, Illinois and New York due to the spread of the disease.

“Public health in our country is both underfunded and equally fragmented,” Phillips said, noting that the current outbreak comes amid an ongoing pandemic and the emergence of increasingly different Covid variants. more virulent.

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

The decision to add federal coordinators to lead the response was met with cautious optimism by some lawyers. But even health officials and experts admit there is little they can do at this point to stop the spread of monkeypox until more vaccines become available. The United States is expected to have only 2 million injections of a two-dose vaccine by the end of the year, which portends prolonged shortages.

Meanwhile, the monkeypox epidemic has grown exponentially, with the number of cases doubling every week. If transmission is not slowed quickly, health experts fear, the country will lose all hope of containing the disease, allowing it to take root as an indefinite threat.

France said the increase in vaccines alone will only be effective if the administration also better coordinates its messages to the affected community. There may be more treatments widely available and more empathy for the afflicted than there was during the AIDS epidemic. But without constructive communication, it wouldn’t work as planned.

“Those of us like me who emerged in the plague years of HIV, 15 years before there was effective treatment, we learned how to put ourselves in a safe and effective way,” France said. “Here’s the message. Here’s the solution. Get them both out at once. Then everyone knows what they have to do and they do it. And right now that message isn’t there. Nobody I don’t know where those vaccines are, if they’re even going to come, if the second dose is going to come. There’s, there’s nobody.”