Monkeypox cases are declining in many areas of the country, but the Biden administration is warning that the virus still poses a danger and pushing for lawmakers to approve its multibillion-dollar funding request to combat it.
More than 23,000 infections have been confirmed in the U.S. during the outbreak, but the growth has slowed. Cases have dropped about 50 percent in the past month, according to the Centers for Disease Control and Prevention (CDC), from an average of 440 cases a day on Aug. 16 to 170 cases a day on Sept. 14.
White House officials are cheering the updates and taking credit for the progress made so far.
“There’s no question that the work we’ve done to rapidly increase vaccine supply, get people vaccinated, [ramp] up the availability of testing and treatments, and educate individuals on how they can protect themselves is making a tremendous difference. The administration’s strategy is working,” Bob Fenton, White House monkeypox response coordinator, said during a recent press briefing.
Officials are also preaching caution and warning that the virus remains a threat, especially if the administration does not have enough funding to help end the outbreak.
“We should note that we have made strong progress, and we’re encouraged by the cases, the case rate of rise declining,” CDC Director Rochelle Walensky said. “And yet we are keeping our — the gas pedal heavily, heavily downward — pedal to the metal — as we continue … the vigilance here.”
The White House requested $4.5 billion for monkeypox response in the upcoming government spending bill. The funding would go towards increasing access to vaccinations, testing, treatment and operational support, as well as helping to combat monkeypox globally.
But Republicans have largely soured on providing any new money, and want the administration to work with what it already has.
“In my view, adding additional funding in that area would make it a very heavy lift for myself and other Republicans,” Sen. Mitt Romney (R-Utah) told reporters. “There’s ample revenue that’s been provided to the administration to be able to deal with medical emergencies of this nature.”
Last week, Senate Minority Whip John Thune (R-S.D.) said Republicans had “zero” interest in providing additional funding.
“There’s plenty of money still swirling around from previous COVID bills … I mean, four and a half billion for monkeypox. That’s a lot of money. And not sure how they’re gonna spend it all,” Thune said.
Senate Health, Education, Labor and Pensions Committee (HELP) ranking member Richard Burr (R-N.C.) told administration health officials during a recent hearing that the government’s response to monkeypox has been plagued by ineptitude, and more money won’t solve the problems.
“It isn’t a question of authority; you have the authority. It isn’t a question of money; you have been given astonishing amounts of money,” Burr said. “It’s a question of leadership. It’s a question of focus. It’s a question of squashing the typical bureaucratic roadblocks, arrogance and ineptitude.”
Unlike with COVID-19, the administration has not previously requested money for the monkeypox response. The White House has been able to tap into its national stockpile of smallpox vaccines, but officials said they are running out of money to replenish it.
In addition, federal officials said they can’t just repurpose previously allocated COVID-19 funding for monkeypox, because legislative language in previous supplemental spending bills restricts the use of funds to COVID-19-related matters only.
Experts and public health advocates stressed the importance of continuing to put resources into the monkeypox response, even as case numbers fall.
“I think it’s too early to make any kind of true definitive statements on where we stand,” said Anne Rimoin, an epidemiologist at the University of California, Los Angeles who has studied monkeypox for decades.
“It appears that we haven’t learned anything … controlling outbreaks, epidemics and pandemics require a sustained effort over a lengthy period of time,” Rimoin said. “If we’re truly going to understand what happened and how to continue to prevent the spread of this virus, we have to put the resources in place to do so.”
David Harvey, executive director of the National Coalition of STD Directors, said sexual health clinics don’t have enough money to continue treating patients without additional resources.
“We have seen this song and dance before, with woeful COVID vaccination rates among minority communities leading to poorer outcomes, and we can’t afford to make the same mistake again,” Harvey said in a statement.
Jen Kates, senior vice president and director of global health and HIV policy for the Kaiser Family Foundation, said the frustrating part of the monkeypox funding stalemate is that it won’t take nearly as much of an investment as COVID-19.
“I think part of the White House argument to Congress and part of the public health argument is, we’re in a window of opportunity here. If we can get the response right and make sure we bring cases down and sustain that,” Kates said. “It’s not a long term investment need.”
During the recent Senate hearing with top administration officials, Sen. Patty Murray (D-Wash.), the HELP Committee chairwoman, questioned whether the government can be trusted to adequately prepare for the next outbreak given the initial missteps in responding to monkeypox.
Still, she said the way to be sure the government is ready is to make sure they have the money they need to prepare.
“I know I’m not the only one here with concerns about the monkeypox response but we can’t just say ‘this isn’t working’ without providing the funding to end this outbreak and build the public health system Americans deserve,” Murray said.