The Biden administration is in a blame game on local authorities for the monkeypox response

Local health authorities and lawmakers have repeatedly called on the Biden administration to take more action in response to the monkeypox outbreak. Now, the White House appears to be holding back by trying to spread the blame to state and local governments.

Health and Human Services (HHS) Secretary (HHS) Xavier Becerra said during Thursday’s press conference on monkeypox that it is ultimately state and local governments that determine how health care is managed in their jurisdictions.

“We believe we’ve done what helps our state and local health care partners stay ahead of this and we’ll continue to monitor because we can’t let this get out of hand,” Becerra said Thursday. “And we will do everything on our part to be a good partner to our state and local governments, who are ultimately the ones who determine how healthcare is managed in their jurisdictions.”

He further stated that the federal government has no control over public health in the “territories and in tribal jurisdiction”.

“They need to work with us,” Becerra said.

The comments come amid persistent criticism that vaccines, tests and treatments for monkeypox remain out of reach for many people as cases have risen to more than 5,000 nationwide. Since the start of the monkeypox outbreak, local and state leaders have called on the White House to provide more help.

In New York, the epicenter of the monkeypox outbreak in the United States, Governor Kathy Hochhol (Dim) and New York City Mayor Eric Adams (Dim) both called on the Biden administration to provide more vaccines and treatments.

When a HHS spokesperson was reached for comment, the HHS spokesperson said Becerra’s remarks were intended to convey that “in a public health crisis, all levels of government — federal, state, local, and tribal — have important roles to play.”

“HHS and the federal government are doing everything they can to provide response tools and support for state and local officials and health care workers who provide care on the front lines, because without them, we will not be able to stay ahead of the virus and end this outbreak,” the spokesperson said.

Marcus Plesia, chief medical officer of the Association of State and County Health Officials (ASTHO), said he and his organization were “a little surprised” by what Becerra said.

“I think we were just a little surprised because this was very collaborative and … it’s never been smooth but it’s as close to smooth as there can be as communication between the Feds and the states,” Plesia said.

Adrian Casalotti, chief of public and government affairs for the National Association of County and City Health Officials (NACCHO), emphasized the need for a strong collaborative effort against monkeypox and noted that local health departments still depend on other parts of American public health. System to work properly against monkeypox.

“For example, except for about five cities, no local health departments get direct access — most of our partners don’t get direct allotment for vaccines,” Casalotti said.

Referring to the lack of supplemental funding for monkeypox, Casalotti said local health departments “are doing all this work within the resources they have and the local health department can’t unilaterally ask Congress for resources.”

Becerra said Thursday that the administration has done what it can to help state and local partners stay ahead of the monkeypox outbreak, but Casalotti said the allocation of resources currently is “really uneven” and many local health departments lack the tools they would ideally have. During an outbreak like this.

“So in all societies, there is work to be done. And this work must be done with the same people who are still fighting the epidemic,” Sai Casalotti. “The same people trying to pick up the pieces from the epidemic, including increased rates of opioids and rates of STDs and decreased vaccinations among children.”

When asked about the possibility of Biden declaring a public health emergency due to the outbreak, as many Democrats in Congress called him recently, both Plessia and Casalotti said it would help improve communication between state and local governments and the White House.

“Generally when there is a national emergency, there are a lot of benefits to that for countries. I mean it tends to make resources more readily available. It tends to sort of speed up the processes that you have to do in order to get things done,” Plesia said.

Plessia said declaring a public health emergency would also help resolve issues with states sharing data with the federal government, which Becerra also indicated could be improved. Casalotti said her organization has been generally supportive of declaring a public health emergency in order to free up resources.

Some local governments such as those of San Francisco and New York have already made their own declarations recognizing monkeypox as either an “imminent threat” or a public emergency within their jurisdictions.

Despite the challenges encountered in the monkeypox strategy, Plesia saw that the United States was still “in a much better position than I would normally expect with an outbreak like this.”

“In political circles and policy circles, we often talk about jurisdiction boundaries. A virus like this doesn’t care about those. And wherever you are, you’re just as safe as the community next door to you. So we really need to work together to end this outbreak,” Casalotti said.