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Becerra gets defensive over Biden administration’s approach to monkeypox

HHS sec’y vaguely blames localities and ‘communities at risk’

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Xavier Becerra, gay news, Washington Blade
HHS Secretary Xavier Becerra got defensive Thursday in response to the Biden administration's approach to monkeypox.

The Biden administration’s top health official got defensive on Thursday in response to questions about its response to monkeypox, suggesting localities and “communities at risk” weren’t doing enough on prevention efforts and asserting the federal government has “done our homework” in addressing the outbreak.

Secretary of Health & Human Services Xavier Becerra made the comments during a conference call with reporters intended to highlight the federal procurement of an additional 786,000 JYNNEOS vaccines from Bavarian Nordic, which are designed to protect against smallpox and monkeypox, amid concerns over a lack of supply causing localities to restrict access to the shots.

When reporters started asking questions about whether the U.S. government could eliminate monkeypox, or simply get ahead of it and whether the disease would become endemic in the United States, Becerra became defensive and downplayed concerns about vaccine availability.

“I almost want to turn that question back at youā€¦and ask you how many vaccines do you think we need at this stage?” Becerra said. “Now there are 330 million Americans. We could try to vaccinate all 330 million but as we’ve seen with COVID, which is far deadlier. There’s not a person who’s died from monkeypox. We’ve lost over a million people from COVID. We still haven’t seen every American get vaccinated with a vaccine that has proven itself to be effective to keep people alive.”

Although challenges have persisted in getting Americans to take now widely available COVID vaccines, the problem with the monkeypox vaccine is supply not meeting demand. The D.C. government announced it would temporarily discontinue a two-shot strategy and offer one shot, which is below the recommended federal guidelines, unless a patient is considered high risk. D.C. Health officials have said the first dose is effective for six months and they anticipate having enough vaccine within that time frame to administer the second doses. Critics have said the Biden administration has not sufficiently ramped up efforts to make vaccines widely available for a disease that has been around since the 1950s.

Meanwhile, the number of cases of monkeypox in the United States, which have occurred almost entirely among men who have sex with men, has reached 3,591. The number of cases is now the highest anywhere in the world.

“So on monkeypox, there are so far less than 5,000 cases reported,” Becerra continued. “So we’ve already made available to jurisdictions throughout the country more than 330,000 vaccines and today we’re announcing that another 786,000 are available. How many more vaccines would you say we need today?”

That’s when Becerra appeared to shift blame over criticism to the government response to localities and “communities at risk,” suggesting they weren’t doing enough to prevent monkeypox. Although Becerra didn’t elaborate exactly on what he meant by prevention for monkeypox, nor “communities at risk,” he compared such efforts to social distancing and masks during the coronavirus pandemic.

“If the response is we’re not going to expect any type of prevention work by the communities at risk, by the state and local officials, then chances are we’re going to have to go to the really high numbers of vaccines,” Becerra said. “But if everyone does their work, and remember containing the virus requires a lot of preventative work ā€” as you know we did masks, that’s why we did social distancing with COVID ā€” we know what we need to do pretty well on monkeypox.”

Becerra went on to promote the federal government’s efforts on monkeypox as rising to the moment, continuing to say state and local officials were responsible for not getting vaccines to populations in need.

“And so to the question: Can we not only stay ahead of this virus, but end this outbreak? Absolutely,” Becerra said. “And we believe that we have done everything we can at the federal level to work with our state and local partners and communities affected to make sure we can stay ahead of this and end this outbreak, but everybody’s got to take the oar and row. Everybody’s got to do their part. We don’t control, as you can see from our lack of data that we’ve gotten from jurisdictions, what they’re doing with their vaccines. We don’t have the authority to tell them what to do. We need them to work with us. And so, I would say that if you’re asking students in the classroom who did their homework, I will raise my hand and say that at HHS, we’ve done our homework.”

Lindsay Dawson, associate director of HIV Policy and director of LGBTQ Health Policy at the Kaiser Family Foundation, told the Washington Blade in response to Becerra’s comments the secretary has a point about the role of localities, but said current problems are at least partly attributed to “barriers at the federal level.”

“Responding to infectious disease outbreaks, including monkeypox, often requires a joint federal and state or local response,” Dawson said. “It is certainly true that local governments have a significant role to play in curbing the current outbreak and that the different decisions they make will likely foreshadow their success to some degree. That said, many of the primary tools to address the monkeypox outbreak, particularly vaccination and treatment, remain limited to date due, at least in part, to barriers at the federal level. Limited access to these tools could challenge local communities in mounting a comprehensive response in the immediate term.”

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The White House

USCIS announces it now only recognizes ‘two biological sexes’

Immigration agency announced it has implemented Trump executive order

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An American flag flies in front of a privately-run U.S. Immigration and Customs Enforcement detention center in the Southeast U.S. on July 31, 2020. U.S. Citizenship and Immigration Services has announced it now only recognizes "two biological genders, male and female." (Washington Blade photo by Yariel ValdƩs GonzƔlez)

U.S. Citizenship and Immigration Services on Wednesday announced it now only “recognizes two biological sexes, male and female.”

A press release notes this change to its policies is “consistent with” the “Defending Women from Gender Ideology Extremism and Restoring Biological Truth to the Federal Government” executive order that President Donald Trump signed shortly after he took office for the second time on Jan. 20.

ā€œThere are only two sexes ā€” male and female,ā€ said DHS spokesperson Tricia McLaughlin in a statement. “President Trump promised the American people a revolution of common sense, and that includes making sure that the policy of the U.S. government agrees with simple biological reality.”

“Proper management of our immigration system is a matter of national security, not a place to promote and coddle an ideology that permanently harms children and robs real women of their dignity, safety, and well-being,ā€ she added.

The press release notes USCIS “considers a personā€™s sex as that which is generally evidenced on the birth certificate issued at or nearest to the time of birth.”

“If the birth certificate issued at or nearest to the time of birth indicates a sex other than male or female, USCIS will base the determination of sex on secondary evidence,” it reads.

The USCIS Policy Manuel defines “secondary evidence” as “evidence that may demonstrate a fact is more likely than not true, but the evidence does not derive from a primary, authoritative source.”

“Records maintained by religious or faith-based organizations showing that a person was divorced at a certain time are an example of secondary evidence of the divorce,” it says.

USCIS in its press release notes it “will not deny benefits solely because the benefit requestor did not properly indicate his or her sex.”

ā€œThis is a cruel and unnecessary policy that puts transgender, nonbinary, and intersex immigrants in danger,” said Immigration Equality Law and Policy Director Bridget Crawford on Wednesday. “The U.S. government is now forcing people to carry identity documents that do not reflect who they are, opening them up to increased discrimination, harassment, and violence. This policy does not just impact individuals ā€” it affects their ability to travel, work, access healthcare, and live their lives authentically.” Ā 

“By denying trans people the right to self-select their gender, the government is making it harder for them to exist safely and with dignity,” added Crawford. “This is not about ā€˜common senseā€™ā€”it is about erasing an entire community from the legal landscape. Transgender, nonbinary, and intersex people have always existed, and they deserve to have their identities fully recognized and respected. We will continue to fight for the rights of our clients and for the reversal of this discriminatory policy.ā€Ā 

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Federal Government

Mass HHS layoffs include HIV/AIDS prevention, policy teams

Democratic states sue over cuts

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HHS Secretary Robert F. Kennedy Jr. (Washington Blade photo by Michael Key)

Tuesday began a series of mass layoffs targeting staff, departments, and whole agencies within the U.S. Department of Health and Human Services under Secretary Robert F. Kennedy Jr., who reportedly plans to cut a total of 10,000 jobs.

On the chopping block, according to reports this week, is the Office of Infectious Disease and HIV/AIDS Policy. A fact sheet explaining on the restructuring says “a new Administration for a Healthy America (AHA) will consolidate the OASH, HRSA, SAMHSA, ATSDR, and NIOSH, so as to more efficiently coordinate chronic care and disease prevention programs and harmonize health resources to low-income Americans.”

The document indicates that “Divisions of AHA include Primary Care, Maternal and Child Health, Mental Health, Environmental Health, HIV/AIDS, and Workforce, with support of the U.S. Surgeon General and Policy team.”

“Today, the Trump administration eliminated the staff of several CDC HIV prevention offices, including entire offices conducting public health communication campaigns, modeling and behavioral surveillance, capacity building, and non-lab research,” said a press release Tuesday by the HIV + Hepatitis Policy Institute.

The organization also noted the “reassignments” of Jonathan Mermin, director of the National Center for HIV, Viral Hepatitis, STD, and TB Prevention, and Jeanne Marrazzo, director of the National Institutes of Health’s National Institute of Allergy and Infectious Diseases. Both were moved to the Indian Health Service.

ā€œIn a matter of just a couple days, we are losing our nationā€™s ability to prevent HIV,” said HIV + Hepatitis Policy Institute Executive Director Carl Schmid. “The expertise of the staff, along with their decades of leadership, has now been destroyed and cannot be replaced. We will feel the impacts of these decisions for years to come and it will certainly, sadly, translate into an increase in new HIV infections and higher medical costs.”

The group added, “We are still learning the full extent of the staff cuts and do not know how the administrationā€™s announced reorganization of HHS will impact all HIV treatment, prevention, and research programs, including President Trumpā€™s Ending the HIV Epidemic initiative,” but “At the moment, it seems that we are in the middle of a hurricane and just waiting for the next shoe to drop.”

A group of 500 HIV advocates announced a rally planned for Wednesday morning at 8 a.m., at the U.S. Capitol lawn across from the Cannon House Office Building, which aims to urge Congress to help stop the cuts at HHS.

“Over 500 advocates will rally on Capitol Hill and meet with members of Congress and Hill staff to advocate for maintaining a strong HIV response and detail the potential impact of cuts to and reorganization of HIV prevention and treatment programs,” the groups wrote.

The press release continued, “HHS has stated that it is seeking to cut 10,000 employees, among them 2,400 CDC employees, many doing critical HIV work. It also seeks to merge HIV treatment programming into a new agency raising concerns about maintaining resources for and achieving the outstanding outcomes of the Ryan White HIV/AIDS Program.”

On Tuesday a group of Democratic governors and attorneys general from 23 states and D.C. filed a lawsuit against HHS and Kennedy seeking a temporary restraining order and injunctive relief to halt the funding cuts.

U.S. Centers for Disease Control and Prevention withdrew approximately $11.4 billion in funding for state and community health departments during the COVID-19 pandemic response, along with $1 billion to the Substance Abuse and Mental Health Services Administration.

ā€œSlashing this funding now will reverse our progress on the opioid crisis, throw our mental health systems into chaos, and leave hospitals struggling to care for patients,ā€ New York Attorney General Letitia James said.  

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State Department

Former US envoy for global LGBTQ, intersex rights slams Trump

Former President Joe Biden appointed Jessica Stern in 2021

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Jessica Stern, the former special U.S. envoy for the promotion of LGBTQ and intersex rights abroad, center, speaks outside the U.N. Security Council on March 20, 2023 (Washington Blade photo by Michael K. Lavers)

Jessica Stern, the former special U.S. envoy for the promotion of LGBTQ and intersex rights, says the work that she and her colleagues did under the Biden-Harris administration is “being systematically dismantled.”

“As the person who was responsible for leading U.S. foreign policy on LGBTQI+ issues, it’s been very difficult for the past two months to see that work being systematically dismantled,” she told the Washington Blade on March 19 during a telephone interview.

Stern was the executive director of Outright International, a global LGBTQ and intersex advocacy group, when then-President Joe Biden appointed her in June 2021.

The promotion of LGBTQ and intersex rights was a cornerstone of the Biden-Harris administration’s overall foreign policy. These efforts specifically included the decriminalization of consensual same-sex sexual relations and marriage equality efforts in countries where activists said they were possible through the legislative or judicial processes.

The Trump-Vance administration’s decision to freeze most U.S. foreign aid spending for at least 90 days has had a devastating impact on the global LGBTQ and intersex rights movement. President Donald Trump’s executive order that bans the State Department from issuing passports with “X” gender markers has prompted Germany and several other European countries to issue travel advisories for transgender and nonbinary people who are planning to visit the U.S.

Stern said the Trump-Vance administration “has studied the anti-LGBTQI strategies of other countries and basically imported the worst ideas from around the world: The most violent, the most dehumanizing, the most targeting strategies.” Stern added these policies have emboldened Hungarian Prime Minister Viktor OrbĆ”n, Russian President Vladimir Putin, Argentine President Javier Milei and other anti-LGBTQ heads of state.

“It’s one thing when a small country that has limited global reach implements anti-LGBTQI laws and policies. It’s another thing when one of the world’s superpowers does so,” Stern told the Blade. “There’s no question that the U.S.’s regression on LGBTQI rights is actually going to accelerate backlash against LGBTQI people around the world.”

“We provide political legitimacy to those ideas, but also we’re forging new alliances and coalitions, and we’re pushing these ideas on other countries,” she added. “So, it’s not a passive action. The U.S. government currently is actively funding and disseminating anti-LGBTQI hatred around the world.”

Former State Department colleagues ‘afraid every day’

The Trump-Vance administration in a Feb. 3 statement that defended its efforts to dismantle the U.S. Agency for International Development noted examples of the organization’s “waste and abuse” included $2 million for “sex changes and ‘LGBT activism'” in Guatemala and $1.5 million to “advance diversity, equity and inclusion in Serbia’s workplaces and business communities.” Secretary of State Marco Rubio last month said 83 percent of USAID contracts have been cancelled, and the remaining will “now be administered more effectively under the State Department.”

Rubio after the Trump-Vance administration froze nearly all U.S. foreign aid spending issued a waiver that allowed the President’s Emergency Plan for AIDS Relief and other “life-saving humanitarian assistance” programs to continue to operate.

The Blade has previouslyĀ reportedĀ PEPFAR-funded programs in Kenya, South Africa, and elsewhere have suspended services and even shut down because of a lack of U.S. funding. UNAIDS Executive Director Winnie Byanyima on March 24 said 6.3 million more people around the world will die of AIDS-related complications over the next four years if the U.S. does not fully restore its foreign assistance.

Stern said her former State Department colleagues are “afraid every day.”

“They never know, ‘Am I going to be fired today?’ “Am I going to be put on administrative leave?’,” she said. “I cannot even imagine what it’s like to go to work every day.”

Stern told the Blade her former colleagues tell her that “there’s not a lot of foreign policy work happening because there’s so much disruption being caused by DOGE (the Department of Government Efficiency).”

“Entire departments have been decimated,” she said, noting one of them has lost 60 people. “It’s almost inconceivable to figure out how to restructure your work when your resources have been decimated.”

Jessica Stern speaks at an LGBTQ+ Victory Institute co-organized conference in Mexico City on July 20, 2023. (Washington Blade photo by Michael K. Lavers)

Stern described herself as “an eternal optimist” when the Blade asked whether she thinks the U.S. can ever stand for LGBTQ and intersex rights abroad.

“You have to believe in human rights,” she said.

Stern said former Secretary of State Antony Blinken as “an ally on LGBTQI issues.” Stern also said many of her now former State Department colleagues thanked her and her team for their work before they left government.

“There’s so much compassion from straight and cisgendered allies, from career officials, people that are not human rights experts or specialists, people that don’t focus on the well-being of LGBTQI people, but people that care very much about the United States standing for its values, the rule of law, equality for all, and this notion that it is in our national interest to ensure that there is safety, prosperity, and well-being for people around the world,” she said.

“The situation we find ourselves in will not last forever,” added Stern. “What we have to do is figure out how to hold the line right now, and how to organize for the future.”

She stressed ways to “hold the line” include litigation, protests, letters-to-the-editor, demanding accountability from lawmakers.

“There’s so much to do,” said Stern.

Then-Secretary of State Antony Blinken speaks at a World AIDS Day event hosted by the Business Council for International Understanding on Dec. 2, 2022. (Screen capture via U.S. Department of State YouTube)

Stern is currently teaching at Columbia University’s School of International and Public Affairs, and is writing about her experience as the “first-ever human rights expert to be the special U.S. envoy for LGBTQI rights.” Stern also told the Blade that she is working to launch a new organization.

“I love being an activist again,” she said. “If there was ever a time when activists are needed, it’s now.”

“I am really proud to have rejoined the resistance,” added Stern.

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