aIf dealing with the ongoing waves of Covid-19 isn’t enough, the United States faces a new outbreak – monkeypox – that highlights how close the US public health system is to a breaking point.
While monkeypox did not Technically Classified as a sexually transmitted infection (STI), it looks and works like a common STI and shares the same barriers to detection and treatment, including stigma and access to knowledgeable providers.
For people like myself who work within the broad national response to monkeypox, there are loud echoes of the early days of Covid-19 and, even longer, AIDS. But understanding the country’s ability to contain monkeypox requires examining the STD epidemic that the nation has ignored for years, which is why these diseases remain out of control.
Consider this: more than 2.5 million Sexually transmitted diseases were diagnosed in 2020, last year with complete statistics. The Inflation rates Touch people of every race, sexual orientation, and even age. Syphilis among newborns Increased 235% since 2016and sexually transmitted diseases such as gonorrhea have arrived Historic heights between teens and adults.
Lack of access to testing, as well as stigma, are major factors in the increases. However, there is no dedicated federal funding to ensure that communities can provide STD testing.
Most Americans are fortunately unaware of the shattered funding flows that make it possible for public health service providers to provide services in their communities. One source of federal funding makes family planning available. Another funded HIV test. Clinics that provide these services also offer community education, treatment and the ability to successfully change health problems – just look at the lower rates human immunodeficiency virus And the teenage pregnancy. Without an outpouring of funding similar to the outbreaks of syphilis, gonorrhea, chlamydia and now monkeypox, there is no foolproof service designed to keep them under control.
It will be difficult for the nation to cure monkeypox if it cannot treat diseases that have been on the rise for decades.
My public health colleagues and I know what to do about monkeypox, just as we know what to do about sexually transmitted diseases. By taking smart steps during an outbreak, we can stop monkeypox in its tracks, while lowering rates of STDs and preparing for future outbreaks. But this can only happen with a serious federal response. Here are three main steps that a response should include:
First, the United States needs to develop a coordinated response to the outbreak immediately. Investing should include testing people with symptoms, which may turn out to be monkeypox but may also be due to something more common and more important, such as syphilis. It is essential to develop point-of-care testing technology and communicate with the public and clinicians so that they know what to look for. The response also needs to be prepared for potential vaccination needs, taking into account bureaucratic hiccups and misinformation.
Second, permanent, dedicated funding should be established for STD clinics and sexual health clinics to provide the same types of services for chlamydia, gonorrhea, syphilis, and other STDs that currently exist for HIV and family planning. This long-awaited dedicated network will make it possible for every community to detect the spread of new infections, such as monkeypox, and permanently treat common sexually transmitted diseases.
Third, the country must continue to invest in success. When Covid-19 appeared in early 2020, Pathological intervention specialists They used their decades of experience in contact tracing for STDs to provide An essential part of the national effort to combat the epidemic. This workforce is now called upon to respond to monkeypox. Congress should make the investment in a pathology intervention specialist permanent.
If HIV and Covid-19 are wake-up calls for the government to prioritize public health, monkeypox shows the consequences of hitting the snooze button too many times. HIV has demonstrated the importance of creating an infrastructure for health care workers who can provide appropriate and competent care for stigmatized infections. Covid-19 has revealed the success or failure nature of coordinated logistics and communications.
The United States is at a crossroads regarding sexually transmitted diseases. It can organize an effective response to monkeypox and provide communities across the country with the necessary infrastructure to enhance health care for all. Or it can keep catching up in one crisis after another and allow common infections to continue to spread between them.
I chose the former. Anyone who chooses the latter is clearly not interested in preserving and promoting the collective health of the nation.
David C. Harvey is Executive Director of the National Coalition of STD Directors.
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