Another emergency right now is vaccine and testing equity. So far in the U.S., Black and Hispanic people have been disproportionately affected by monkeypox—with disparities that are increasing over time—yet they are receiving a lower share of vaccines. The inequities are even worse globally. Not a single vaccine has been given in any African countries where monkeypox has been endemic for decades, and test kits have been in short supply in these countries. This isn’t just an urgent moral problem. It’s also shortsighted: Inequity will result in continued cases around the world, including in the U.S., and make it harder to curtail the virus.
Elimination in many places is a real possibility. If animal surveillance—which must also be expanded—shows that the virus is circulating only in humans in the countries experiencing new outbreaks, “then this disease is in theory a candidate for elimination,” Rivers said. “I think that that’s still on the table. I don’t think the window has closed.” And even if the virus isn’t eliminated entirely, pushing cases as low as possible would be a huge public health win.
The worst thing we could do now is to see cases are falling and believe the problem is going away. With Covid, for instance, we breathe a sigh of relief every time a surge peaks and then falls. But often, there are more people infected—and more people dying—on the long downslope of a drawn-out epidemic as the virus continues spreading. The downward trend is seductive, tempting us to tell ourselves we’re out of the woods now and we can ease up on our response. But thinking we are done with monkeypox is the surest way for the virus to remain a serious threat.