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U.S. monkeypox response stirs up anxious memories of AIDS era for activists

One “reason why people feel the parallels so keenly now is because of the rise in anti-LGBTQ sentiment, which also preceded HIV,” said France, now a filmmaker whose work includes “How to Survive a Plague.” , an Oscar-nominated documentary about the fight against AIDS.

He and other proponents have increasingly criticized the Biden administration and the health community around the world for being too slow on monkeypox testing and vaccines, and for not clearly communicating the risks of the disease to the public. community that has been overwhelmingly affected: men having sex with Gentlemen. The first confirmed case of monkeypox in the US this year was recorded on May 18; there are now more than 6,320 nationwide – a number expected to rise significantly.

“I am incredibly angry that we have let it spread this far, and that the federal government has failed to figure out how to ramp up testing quickly, to figure out how to do active surveillance to make sure that vaccines and treatments were there when they needed to be,” said Gregg Gonsalves, a global health activist and epidemiologist at Yale University.

The government appears to be finally addressing these concerns. In an effort to improve response and blunt criticism, President Joe Biden on Tuesday appointed senior officials from the Federal Emergency Management Agency and the Centers for Disease Control and Prevention to lead the national monkeypox fight.

Robert Fenton, a longtime FEMA official, gained the trust of the White House during the Covid vaccine rollout for helping set up the administration’s network of Covid vaccine sites. He is expected to manage the logistics at the heart of the response, including efforts to accelerate 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 known for his work engaging the LGBTQ community on public health issues — expertise likely to guide will serve the government’s commitment to transfer 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 up to the health department to direct the response to monkeypox. But the department’s leadership has struggled to coordinate the sprawling efforts, which has led to vaccine and testing shortages and intense criticism from activists and health experts. Response is still hampered by difficulties in collecting data from individual states, allowing cases to spread largely undetected across the country.

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

Although monkeypox, unlike AIDS, has a vaccine, the disease is spreading fast enough to force people who have lived through that past crisis to see parallels with it. Chief among these is a growing awareness among activists that, decades later, public health officials are making missteps that can make LGBTQ people feel like an afterthought again.

“This time they had the tools, right?” said France. “They had the vaccines and they had a connection to the community, who they could message about prevention.”

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

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

“There are some similarities among the community affected by this disease. The pain, the suffering, the fear of stigma, but this time in the White House it was no laughing matter,” 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 within a month, White House officials said. Despite the first deliveries there are still shortages, especially in the worst affected cities. In the past 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 both underfunded and fragmented,” Phillips said, pointing out that the current outbreak comes amid an ongoing pandemic and the emergence of increasingly virulent Covid variants.

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

The move to add federal coordinators to lead the response was met with cautious optimism by some proponents. But even health officials and experts admit there’s little they can do right now to stop the spread of monkeypox until more vaccines become available. The US is expected to have just 2 million injections of a two-dose vaccine by the end of the year, resulting in predictions of long-term shortages.

The monkeypox outbreak has since grown exponentially, with the number of cases doubling each week. If transmission isn’t slowed down soon, health experts worry, the country will lose all hope of containing the disease, leaving it to be entrenched as an undetermined threat.

France said increasing vaccines alone will not be effective unless the government also better coordinates its messages to the affected community. There may be more widely available treatments and more empathy for those affected than during the AIDS epidemic. But without constructive communication it would not work as planned.

“Those of us like me who emerged in the HIV plague years, 15 years before there was an effective treatment, we learned how to position ourselves in a safe and effective way,” France said. ‘Here’s the message. Here’s the solution. Take them both out at the same time. Then everyone knows what to do and they do it. And right now that message isn’t there. Nobody knows where those vaccines are, if they’re coming, if the second dose is coming. There is, there is nobody.”

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