On Sept. 14, the Senate Health, Education, Labor, and Pensions Committee held a hearing entitled, “Stopping the Spread of Monkeypox: Examining the Federal Response.” This hearing follows the White House’s emergency supplemental funding request.
Committee Chair Patty Murray (D-Wash.) in her opening statement, emphasized the importance of a robust, more equitable response to monkeypox and urged quick action on testing, treatments, vaccines, and equipping the public, health care providers, and public health officials with clear guidance. She pointed out the difficulties patients and providers have dealt with in accessing tests and treatments and warned about worsening inequities as a result of the outbreak. She noted the disproportionate impact the monkeypox outbreak has had on Black and Latino communities and the stigmatization of the LGBTQ+ community. She also expressed support for her legislation, the bipartisan PREVENT Pandemics Act, which is awaiting Senate floor consideration [refer to Washington Highlights, March 18]. Murray concluded her statement by reiterating the importance of investing in our public health system and public health infrastructure, and “work[ing] together to build on our progress, end this crisis, and make the kind of improvements we need to put our public health security on solid footing once and for all.”
In his opening statement, Ranking Member Richard Burr (R-N.C.) expressed his disappointment toward what he described as the lack of testing and inability to access tests, the vaccine rollout, the lack of clear guidance to the public and health care providers, and the overall response to the monkeypox outbreak thus far. He also stressed the importance of “a consistent and coherent government-wide response” and stated that he would commit to “doing everything [he] can to help the White House set that new [Office of Pandemic Preparedness and Response Policy] up with a lasting mission and clear agenda.”
The committee heard from Rochelle Walensky, MD, MPH, director of the Centers for Disease Control and Prevention (CDC). She outlined the steps the CDC has taken since the first monkeypox case in the United States, and how the agency has ramped up its efforts in response to outbreaks. Though she noted the decreased rate in new cases, she stressed that this news should be approached with “cautious optimism.” Walensky also emphasized the critical role provider education has played in the CDC’s response, and how the agency has relied on public health, LGBTQ+ advocates, as well as community-based organizations to define and amplify their messaging. She reiterated the necessity of sustained investments and additional policy levers to mounting a robust response and building and maintaining a modern public health system and called on Congress to address the White House’s emergency supplemental request.
The committee also heard from Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID) and the chief medical advisor on President Joe Biden's COVID-19 Response Team. He provided historical context to NIAID monkeypox research efforts and reiterated that while men who have sex with men have been disproportionately impacted, anyone exposed to the virus can get infected regardless of age, gender identity, or sexual orientation. He also emphasized that the lessons learned of avoiding stigma and ensuring that medical countermeasures are equitably applied should “inform our response to the inevitable next emerging or reemerging infectious disease of pandemic potential.”
Robert Califf, MD, commissioner of the Food and Drug Administration (FDA) walked the committee through his agency’s response to the monkeypox outbreak. Califf detailed how the agency accelerated vaccine production and why the FDA granted emergency use authorization for intradermal vaccine administration. He also stated that though there are no FDA-approved monkeypox treatments, tecovirimat (also known as Tpoxx) has been made available to patients via the CDC’s expanded access investigational new drug protocol. When later asked by Murray about the availability of tests, he clarified that, "there's never been a shortage of tests, but there's been a shortage of access to tests because of inefficiencies in the system.”
Finally, the committee heard from Assistant Secretary for Preparedness and Response Dawn O'Connell, JD. She detailed the Administration for Strategic Preparedness and Response’s (ASPR’s) procurement and distribution of the Jynneos monkeypox vaccines and their ongoing COVID-19 and monkeypox response. O’Connell noted that ASPR has 1.1 million available vials of Jynneos for states and jurisdictions and has purchased 5.5 million more vials. The Strategic National Stockpile (SNS) has also made 1.7 million courses of the Tpoxx therapeutic available and distributed over 37,000 courses. She also emphasized that it is imperative to preserve the nation’s smallpox capacity, even as public health leaders and officials continue with their monkeypox response. O’Connell noted that ASPR has taken steps to modernize the public health infrastructure by digitizing the SNS countermeasure ordering system and utilizing the Health Partner Order Portal to distribute both monkeypox vaccines and treatments from SNS.
When asked by Murray what ASPR is doing to increase access to vaccines, O’Connell responded that they are “in the business right now of knocking down those hurdles [to obtaining the vaccine] and making sure the vaccine can be accessed.”
- Washington Highlights