Former Food and Drug Administration (FDA) Commissioner Scott Gottlieb wrote an op-ed in the New York Times published Saturday, arguing that the United States does not have a federal infrastructure capable of dealing with emergency situations in the United States. areas of public health, such as monkeypox and COVID-19.
“Our country’s response to monkey pox is plagued by the same shortcomings we had with Covid-19,” Gottlieb wrote in the opinion.
“If monkeypox now gains a foothold in the United States and becomes an endemic virus to join our circulating repertoire of pathogens, it will be one of the greatest public health shortcomings in modern times, not only because of the pain and the danger of the disease, but also because it was so avoidable,” he said. “Our mistakes extend beyond political decision-making to the agencies responsible for protecting us from these threats.”
Gottlieb said the country wasn’t testing enough people for monkeypox in the early days of the outbreak, noting that the Centers for Disease Control and Prevention (CDC) didn’t expand testing to major commercial labs until late June.
“His cultural instinct is to take an informed approach and discuss every decision,” he said of CDC. “With Covid, the virus has quickly gained ground. With monkeypox spreading more slowly, usually through very close contact, the shortcomings of CDC’s cultural approach have not been so acute. But the shortcomings are the same.”
CDC has reported nearly 5,200 cases as of Sunday, and the outbreak has reached all but three states: Montana, Vermont and Wyoming.
Monkeypox spreads through close contact with an infected animal or person, usually through lesions, bodily fluids, contaminated materials, and respiratory droplets. Those droplets can only travel a few feet and usually require prolonged contact for transfer.
The virus has been found largely in men who have sex with men, leading some jurisdictions to prioritize those groups to receive the currently limited number of vaccine doses against monkeypox.
Gottlieb called on the CDC to continue to lead the country’s pandemic response, but argued it should transfer some of its disease prevention work to other agencies.
He called on the FDA to manage smoking and the National Institutes of Health (NIH) to tackle cancer and heart disease.
“Focus the CDC more on its core mission of response to outbreaks,” Gottlieb wrote. “And imbues the agency with the national security mentality it had at its origin. If the CDC mission were more tightly focused on the elements needed to deal with contagion, Congress would be more willing to invest it with the robust authority to properly carry out that focused mission.
But Gottlieb questioned the feasibility of reforms to equip CDC and other public health agencies with new tools and authority, citing his talks with lawmakers and their staffs that showed what he called a “little appetite” for such a move.
“After Covid, there is an opinion among some that public health authorities have used flawed analysis and miscalculated their advice,” Gottlieb wrote. “Securing a political consensus that the CDC should be further empowered to complete its mission — invested, for example, with the power to enforce reporting from states — is politically unachievable.”