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Reps. Nadler, Cicilline Lead Letter to Biden Admin Urging Additional Funding for Clinics to Address Monkeypox

Washington, July 25, 2022

Washington, D.C. - Today, Representatives Jerrold Nadler (D-NY) and David Cicilline (D-RI), Chair of the Congressional LGBTQ+ Equality Caucus, led a group of more than 100 members of Congress in sending a letter to the Biden Administration urging additional funding for sexual health clinics across the country to implement federal monkeypox response efforts. More than 100 organizations endorsed the letter, including the New York State Department of Health, National Coalition of STD Directors, National Coalition of LGBTQ Health, Whitman-Walker Health, Human Rights Campaign, and others.  

In their letter, the Members wrote: “As monkeypox cases continue to rise, states and communities are heavily relying on health clinics’ expertise in disease detection, contact tracing, symptom monitoring, and community education, as well as their community connections, to help slow the spread of this virus. In cities across the U.S., clinics that provide essential family planning, sexual health, and other vital services have now been urgently tasked with expanding appointment capacity, acquiring tests and vaccines, and working with local communities to mitigate the spread of monkeypox.”

The Members continued: “We respectfully request that $100 million in funding be dedicated to implement federal monkeypox response efforts, including at least $30 million for the STI field funded through the CDC’s Division of STD Prevention, to ensure that our nation’s clinics and providers have the resources and infrastructure needed to conduct the following:

    • Scale outreach efforts to people in specific communities, including but not limited to men who have sex with men (MSM), so individuals are armed with the information they need to protect themselves;
    • Support clinical education to help physicians and other health care professionals to identify and properly diagnose monkeypox and differentiate it from STIs, and connect patients with treatment, pre-exposure prophylaxis and post-exposure prophylaxis, social services, and other health care;
    • Develop more efficient diagnostic tools;
    • Build up real-time surveillance and outbreak detection;
    • Bolster the public health workforce to ensure an adequate response to monkeypox to prevent the current outbreak from further exacerbating rising STI rates; and
    • Administer vaccines to communities and healthcare workers to bolster the response as the needs arise.”

Full text of the letter can be found below and here. In addition, a full list of endorsing organizations can be found here.


July 25, 2022

Dear President Biden, Secretary Becerra, and Dr. Walensky:

We write to commend your administration’s recent actions to increase supplies of monkeypox vaccines and improve testing and laboratory capacity across the country. We respectfully request additional funding to support health clinics as they work to implement this federal monkeypox response.

As monkeypox cases continue to rise, states and communities are heavily relying on health clinics’ expertise in disease detection, contact tracing, symptom monitoring, and community education, as well as their community connections, to help slow the spread of this virus. In cities across the U.S., clinics that provide essential family planning, sexual health, and other vital services have now been urgently tasked with expanding appointment capacity, acquiring tests and vaccines, and working with local communities to mitigate the spread of monkeypox.

We are concerned that continued underfunding of sexually transmitted infection (STI) clinics—in addition to significant staffing shortages exacerbated during the pandemic—is limiting front-line health professionals’ ability to fully execute these critical services and prevent the spread of this virus. Although monkeypox is not a STI, it is being transmitted through sexual networks and is currently presenting with symptoms frequently seen with other STIs. STI clinics are uniquely positioned in the community to respond to the outbreak and have the skills and expertise to play a central role in the monkeypox response. Still, they need testing kits and other supplies and additional staff to scale up an appropriate response.

Traditionally, state, and local governments have funded STI clinics, and this funding has declined dramatically over the last 20 years. Publicly funded STI clinics have an important role in providing comprehensive sexual health care services particularly for MSM who are currently disproportionately affected by the monkeypox outbreak. As published last year in the Morbidity and Mortality Weekly Report (MMWR) – Surveillance Summary the number of annual visits available in STI clinics in the major cities surveyed has dropped by almost a third while the number of patients identifying as MSM has increased in these clinics by 44%. These are the cities at the front lines of this outbreak.

While your administration has taken several important steps in the initial response, it is imperative that health clinics are equipped with additional funding and resources to continue working to slow this expanding outbreak.

For this reason, we respectfully request that $100 million in funding be dedicated to implement federal monkeypox response efforts, including at least $30 million for the STI field funded through the CDC’s Division of STD Prevention, to ensure that our nation’s clinics and providers have the resources and infrastructure needed to conduct the following:

  • Scale outreach efforts to people in specific communities, including but not limited to men who have sex with men (MSM), so individuals are armed with the information they need to protect themselves;
  • Support clinical education to help physicians and other health care professionals to identify and properly diagnose monkeypox and differentiate it from STIs, and connect patients with treatment, pre-exposure prophylaxis and post-exposure prophylaxis, social services, and other health care;
  • Develop more efficient diagnostic tools;
  • Build up real-time surveillance and outbreak detection;
  • Bolster the public health workforce to ensure an adequate response to monkeypox to prevent the current outbreak from further exacerbating rising STI rates; and
  • Administer vaccines to communities and healthcare workers to bolster the response as the needs arise.

At this critical moment, we cannot risk making the same mistakes that caused the United States to fall behind in testing capacity during the initial COVID-19 outbreak, and we cannot ignore the critical lessons learned from both the HIV and STI epidemics. We urge your administration to dedicate much-needed funding to clinics as they work to protect the growing number of individuals who have been recently exposed to monkeypox and to proactively protect all high-risk individuals against this virus.

If we do not provide sufficient funding for our nation’s STI clinics now, it will become significantly more challenging to eradicate monkeypox in the months ahead.

Thank you for your attention to this matter. We look forward to your prompt response.
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