Government watchdog criticizes federal mpox response

The Government Accountability Office (GAO) says in a new report that the Department of Health and Human Services’ (HHS) response to the 2022 mpox outbreak was uncoordinated and lacked interagency cohesion.

For its report, the GAO visited 14 U.S. jurisdictions, including Los Angeles, Miami Dade County, Atlanta, Chicago and New York. The agency also interviewed nongovernmental stakeholders and reviewed actions taken by HHS in response to previous GAO recommendations.

The audit was carried out from October 2022 until this month.

As GAO noted, the mpox response was carried out across numerous agencies within HHS, including the Administration for Strategic Preparedness and Response (ASPR), the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration, the National Institutes of Health and the Health Resources and Services Administration.

Although the declaration of a public health emergency accelerated the response, several officials in the jurisdiction said there did not appear to be a “central point of coordination until the White House team stepped up” in August, about three months after the first case. of mpox in the USA. the outbreak was detected.

“For example, officials from several jurisdictions spoke about the challenges of working with CDC and ASPR and said that the two agencies regularly directed questions or requests from jurisdictions to the other agency,” the GAO report said.

“HHS could have responded to jurisdictions’ questions and requests more quickly if there had been greater coordination among all HHS agencies.”

According to the report, HHS officials said ASPR served as a central coordinator for some parts of the government’s response to the mpox outbreak.

GAO determined that other errors in HHS’s response included failing to effectively communicate the elevated risk of infection to certain individuals, particularly men who have sex with men. An official from one of the jurisdictions told GAO that this type of information could have helped prevent infections.

Officials apparently acknowledged, however, that the response improved after HHS incorporated community input. But other challenges in working with the federal government continued to emerge.

Supplies of Jynneos smallpox vaccines used to combat the outbreak have been boosted by administering intradermal injections one-fifth the size of a normal dose. Although this availability has improved, the supplies needed to administer these injections have not been provided as some health officials expected due to the COVID-19 pandemic.

And reporting data to the federal government was time-consuming, as officials often described the need to manually upload data from case reports.

In response to its review, GAO issued two recommendations.

First, it recommended that the HHS Secretary “develop and implement a department-wide coordinated after-action program that encourages collaboration among HHS component agencies, including integration of these component agencies’ existing public health emergency after-action programs “.

Second, the office recommended that the secretary develop an after-action program that includes “stakeholders involved in each public health emergency response – such as other federal agencies, jurisdictions, and nongovernmental partners.”

When reached for comment, an HHS spokesperson said the department “agrees with both recommendations and is working on implementation.”

Democratic Reps. Bennie Thompson (Miss.) and Ritchie Torres (N.Y.) and former Rep. Val Demings (D-Florida) called for the GAO review in August 2022, saying at the time that they were “concerned about the pace of the federal response monkeypox allowed the virus to spread for two months, and delays in distributing tests and vaccines hampered efforts to contain the virus.”

In response to the report, Torres announced that he was introducing the Coordinated Agency Response Enhancement Act, which, if enacted, would require the HHS Secretary to develop after-action programs that encourage interagency collaboration and develop culturally sensitive risk assessment strategies. sensitive and inclusive.

“In the aftermath of the COVID-19 pandemic and the Mpox outbreak, it is time to radically shift our federal approach to public health. Marginalized and at-risk communities cannot afford to bear the brunt of another health emergency public, desperately hoping that the government decides to act together,” Torres said in a statement.

—Updated at 6:25 p.m.

This story originally appeared on thehill.com read the full story