Monkeypox Is Yet Another Global Health Crisis Fueled by Governmental Neglect

It’s hard not to think about AIDS when thinking about monkeypox — the media images of otherwise healthy gay men covered in sores, the homophobic anti-sex puritanism from people across the political spectrum, and the widespread culture of blame and shame directed at queer sexual pleasure. Stigma, as usual, distracts from the real problem which in this case is the US government’s utter neglect.

Every queer person has to deal with the AIDS crisis. One generation experienced sexual liberation in 1970s and then watched their friends die from mysterious illnesses while the government did not intervene. There is a generation who grew up in the midst the AIDS crisis and absorbed the trauma of mass deaths as part of being queer. A new generation is emerging, with effective treatment options and prevention, but still dealing with the AIDS crisis on all levels.

If you are familiar with the ongoing trauma caused by HIV/AIDS, you will see that there are many parallels in the treatment of the monkeypox outbreak in America. Unlike the AIDS crisis of the early years, where no effective treatments were available, and a decade of mass killing and public protest forced government and pharmaceutical industry into action, monkeypox has not become a deadly disease. We already have the tools to treat and prevent it. The problem is the lack of access to care.

Three months after the outbreak of monkeypox in the U.S., federal officials have declared the disease a national emergency. This may allow more resources to be directed at those in need. But if the government had acted with a sense of urgency right away, and distributed the vaccine immediately to those most at risk, then it’s possible that monkeypox wouldn’t have become such a crisis.

Monkeypox is not a new phenomenon in America, but the virus has been around for decades in Central and West Africa. 2017 saw a devastating outbreak. The U.S. government decided to let 20 million doses from its strategic stockpile of vaccines expire, rather than using them to help Nigerians afflicted by the disease. Maybe monkeypox would have been a less serious problem if the 20 million doses had been sent five years ago to Nigeria. Not only that, but the people who were affected would have been able to get the treatment they needed. Even though the vaccine and medication are still not available in Nigeria, the outbreak that began in 2017 continues.

Terms like “vaccine apartheid” and “vaccine hoarding” have been popularized during the COVID pandemic, but vaccine hoarding predates the COVID crisis. What is it called if you have 20 million doses of an expired vaccine and instead of giving it to those who need it? You can’t blame this on governmental ineptitude. It is a result of racist arrogance, and the legacy of colonialism.

Every article about monkeypox should state that the U.S. government is a cause of this crisis, instead of shifting the blame onto individual acts and policing people’s sex lives while refusing to challenge the structural violence that continues, along with its devastating consequences.

As virologist Joseph Osmundson says, “Gay sex is not driving this epidemic, this epidemic is being driven by a lack of access to resources globally that could prevent spread. People want to get vaccinated, and they can’t get vaccinated.”

Here in the United States, there is an extreme shortage of the Jynneos vaccine, and mass panic among the people most affected by monkeypox in this country — at least 97 percent of the reported cases are among gay and bisexual men, and trans, genderqueer and nonbinary people who are part of their sexual networks. So across the U.S., we see the dystopian spectacle of queer folks desperately waiting in line for hours and hours to get the vaccine — 10 hours outside a bathhouse in Berkeley; five hours in hospital hallways in Seattle and San Francisco; outside in a sweltering New York City heat wave. Sometimes, people are forced to wait in line for hours only to be turned down because the vaccine is out of stock.

None of this is necessary. It’s been over a year since COVID vaccines were rolled out, when hundreds of people were vaccinated at a time in some locations, thousands of doses a day in many cities, and now most cities don’t even have thousands of doses of the monkeypox vaccine in total. So why couldn’t the same kind of care and attention be directed to administering the monkeypox vaccine quickly and effectively, without adding to risk or vulnerability, while we are still in the midst of the COVID pandemic? This is being done just across the border in Canada, while in the U.S. we’re faced with a top-down model of scarcity and a “while supplies last” mentality of vaccine availability: Get in line, shoppers, the wait is definitely worth it… If you’re still standing.

Monkeypox patients are often in extreme pain. They don’t have the financial support they need to isolate the disease and they also don’t have access to the antiviral medication. This is because Tpoxx can only be obtained through a complicated CDC protocol.

Who has this knowledge? The information about the location, treatment, and timing of monkeypox and the vaccine has been passed anecdotally to the most affected through their social and sexual networks. This is a recurrence of the early years AIDS crisis. There is potential in sharing strategies to beat the system, but not if it is causing you unnecessary pain and distress. And, this informal sharing of knowledge prioritizes the people who already have the most access — often wealthy and white — furthering the privatization of a public health system that barely serves the people most in need, including poor people, people of color, and undocumented, disabled and unsheltered people.

As queer people seek the information, knowledge and access they need to care for one another in an AIDS crisis, the brutality that is a resurgent sexual moralism comes back to the forefront. This is a country moving backwards. Viruses don’t cause stigma, people do. Although we already have the tools to treat monkeypox, and prevent its spread, the U.S. government, as we’ve seen with the ongoing COVID epidemic, is far more adept in abandoning those most vulnerable than providing care. In the midst the COVID pandemic and the AIDS crisis, we face another unneeded global health crisis that is exacerbated by structural racism, homophobia, and homophobia.