Biden administration estimates US may need nearly $7 billion for monkeypox


The Biden administration privately estimated in Congress this month that it may need nearly $7 billion to mount a response to the country’s monkeypox outbreak that matches “the magnitude and urgency of the current situation”.

The funding estimate, details of which were in a memo to President Biden and obtained by The Washington Post, reflected early talks between congressional Democrats and White House officials seeking a spending package that would could increase the availability of monkeypox tests, vaccine doses and treatments.

The amount did not mark a formal request for assistance from Congress. Rather, it was one of a series of options reflecting various amounts that could fund various levels of federal mitigation efforts. White House aides recently pitched the ideas at the request of Democratic leaders on the top health-focused Senate committee, according to the memo. A Democratic aide, who spoke on condition of anonymity to describe the private conversations, confirmed the funding details to The Post.

The Biden administration has also requested up to $31.4 billion in new funding to fight the coronavirus pandemic as it seeks to ensure the government has the resources to buy more treatments, tests and vaccines. This year.

The White House had already repeatedly urged Congress to approve another tranche of aid targeting covid-19. But Republicans raised numerous fiscal objections to additional federal spending, leading to a standoff that forced the Biden administration to ration remaining funds. New discussions around monkeypox aid could face similar political hurdles, as some GOP lawmakers have previously said they are only willing to reallocate existing funds, not authorize new dollars.

The private discussions came as public health experts warn that monkeypox, which can be spread through skin-to-skin contact and cause fever, sores and severe pain, is at risk of taking permanent root. in the USA. Federal officials have identified about 3,500 cases, mostly among gay and bisexual men, and have warned that the virus is likely to spread to wider populations.

The World Health Organization declared the global monkeypox outbreak a public health emergency of international concern on Saturday, its highest warning, and Biden officials are considering a similar declaration, although the current outbreak is n has not yet been linked to deaths in the United States.

After this story was published, an administration official confirmed ongoing White House discussions with Congress about funding monkeypox.

“As part of our routine conversations with Congress about various resource needs, the administration responded over the weekend to a request from Hill staff for additional information on the administration’s response efforts to public health, including our response to the monkeypox outbreak and the additional resources needed to pursue it, the official, who spoke on condition of anonymity, wrote in an email.

According to the memo obtained by The Post, officials estimate that $6.9 billion in new funding for the monkeypox response would allow the Department of Health and Human Services to support “vaccine manufacturing capacity and transfer end-to-end technology” in the United States. . The only vaccine specifically approved by the Food and Drug Administration for monkeypox, Jynneos, is produced in Denmark, which has led to significant complications in the US response – for example, hundreds of thousands of doses of Jynneos have been stuck overseas for weeks, awaiting inspection and transport by the United States.

With that much funding, officials further estimate that they would be able to secure 19 million new doses of monkeypox vaccine and replenish about 4 million doses for interrupted smallpox preparedness efforts, as well. to purchase more antiviral treatments, expand testing, improve vaccine distribution, and provide service coverage to uninsured and underinsured Americans, among other goals.

Health officials also estimated the effects of a second “medium” option, seeking $2.2 billion in monkeypox funding to purchase doses of vaccines and treatments that would be targeted at the gay community and bisexual, where the epidemic is currently concentrate. But the amount can only provide an effective response if the outbreak remains contained and does not spread to wider populations, “which is not guaranteed,” the memo warns.

Officials also estimated a simple $500 million fallback option that would buy some vaccine doses and continue with “minimal” operations.

Health officials said they are funding the current response to monkeypox using existing appropriations and a response fund managed by the Centers for Disease Control and Prevention. The Biden administration has distributed 330,000 vaccine doses and contracted for a total of 6.9 million doses of Jynneos by mid-2023, in addition to other investments in testing and treatment.

The talks come as Democrats on Capitol Hill sound the alarm about the need for the federal government to act quickly and more aggressively. Party lawmakers sent a flurry of letters over the past week that showed some of their unease with the situation, in some cases saying the US government hadn’t done enough to offer testing, treatment and vaccinations to those who needed them most.

In a letter to the Biden administration sent Monday, more than 100 House Democrats led by Reps. Jerrold Nadler (DN.Y.) and David N. Cicilline (DR.I.) called for “additional funding.” that could support health clinics tasked with responding to monkeypox. Lawmakers said the lack of financial resources has jeopardized local work to carry out contact tracing and provide other essential services, increasing the burden on doctors and aides who are already overstretched due to the coronavirus pandemic. .

“What we hope is that the covid experience will inform the response to this epidemic,” Cicilline said in an interview on Tuesday.

Separately, 22 other Democrats led by Senators Jeff Merkley (D-Ore.) and Edward J. Markey (D-Mass.) expressed growing “concern” about the number of recent cases and called on the administration Biden to increase access to vaccines. Lawmakers said the vaccine shortage has hurt “at-risk” populations, particularly lesbian, gay, bisexual and transgender communities, for whom health care may already be “inaccessible or otherwise denied”.

“In light of this high demand and the communities that have been impacted by the outbreak in the United States to date, we implore you to work urgently to take the necessary steps to respond to this public health issue and ensure adequate doses and equitable distribution. vaccine in the United States,” the Democrats wrote in their missive.

And Markey further called on the CDC on Tuesday to “lower the barriers” to accessing a key treatment, known as tecovirimat, that has been difficult to obtain for monkeypox patients. In doing so, Markey asked HHS and CDC officials if they needed “additional funding” to ensure its availability.

Meanwhile, Senate Republicans continued to pressure the White House over its emerging response to monkeypox and its ongoing response to the coronavirus. Sen. Richard Burr (RN.C.), the top Republican on the Senate health panel, earlier this month sent a letter to Biden officials, criticizing their “gross failures” on monkeypox testing and distribution of vaccines and demanding the administration’s “detailed strategy” on how to respond to the current outbreak. Burr also spent months warning the White House that he did not plan to support more coronavirus funding until he was assured that trillions of dollars in earlier funding had been well spent.

Broadly, Republicans demanded that Democrats reallocate past stimulus dollars to cover the costs of any new public health spending. Without GOP support, Democrats cannot advance any aid agenda in the tightly divided Senate.

The Biden administration has repeatedly called for more coronavirus funding, warning it is increasingly being pressured to shift money from other needed initiatives, such as a decision last month to levy $10 billion. on testing and other programs to buy more vaccines. The White House on Tuesday hosted experts who argued for “the next generation” of coronavirus vaccines that could last longer and offer more protection against the virus, the administration’s latest effort to underscore the need for more investments.

“We need to keep innovating, being creative and bringing big ideas to life. We must continue to fund these ideas with the support of Congress,” said Alondra Nelson, acting director of the White House science office.

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