Mpox—formerly known as monkeypox—is a contagious disease characterized by flu-like symptoms and a painful rash that can last for weeks. Mpox has two distinct genetic clades, I and II. Clade I mpox has previously been observed to be more transmissible and cause more severe infections than Clade II mpox.
In 2022, the World Health Organization (WHO) declared the existence of a multi-country outbreak of Clade II mpox as a public health emergency of international concern. During that outbreak there were more than 95,000 cases of mpox across 115 non-endemic countries. In the U.S., cases of Clade II mpox have continued to spread at low levels.
Meanwhile, in 2024, the WHO determined that the upsurge of Clade I mpox in the Democratic Republic of the Congo (DRC) and a growing number of countries in Africa constitutes a public health emergency of international concern.
U.S. public health agencies have been closely monitoring the spread of Clade I mpox in the DRC and neighboring countries since 2023. In November of 2024, the first known case of clade 1 mpox in the U.S. was reported in a person in California who had recently traveled from Eastern Africa. However, the overall risk of the U.S. public from Clade I mpox remains low.
A resolution on mpox introduced by the AMA LGBTQ+ Section and adopted by the AMA House of Delegates at the 2024 AMA Interim Meeting in Lake Buena Vista, Florida stressed the need for comprehensive action to ensure equitable access to resources and protect public health.
“A 2022 survey assessing the opinions of gay and bisexual men—the population disproportionately affected by mpox—on the U.S. response to the mpox outbreak found that nearly 50% rated it as only fair to poor, with civil unrest and dissatisfaction demonstrated through protests by LGBTQ+ activists in cities like New York and San Francisco at the peak of the outbreak,” says the resolution.
Despite mpox vaccination effectiveness of up to 89%, concerns about addressing an mpox outbreak include a lack of public health organizational response to readily dispense vaccines, perceived costs and accessibility to acquire the vaccine, as well as slow progress on research to develop new vaccinations.
“Although mpox is not currently circulating widely in the U.S., we should remain vigilant and take steps to prepare for and prevent the potential future spread of mpox,” AMA Trustee Lynn Jeffers, MD, MBA said in a statement. “That’s why we’re encouraging coordinated national and international efforts to address mpox, including global surveillance, resource sharing, research and outreach programs that enhance public knowledge of mpox transmission, prevention and vaccine effectiveness, particularly in resource-constrained settings.”
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Mpox is a public health threat
This concern isn’t new though. LGBTQ+ populations have encountered economic, physical and mental health inequities and have historically been neglected by public health and governmental response to diseases that predominantly affect these populations, as exemplified by the HIV/AIDS pandemic.
The AMA House of Delegates adopted new policy to:
- Promote the recognition of mpox as a public health threat and the need for ongoing surveillance, preparedness, and resource allocation to prevent future outbreaks.
- Urge federal, state and local agencies—in collaboration with public health organizations and medical associations—to develop and implement effective strategies for the prevention, control, and management of mpox, with particular focus on marginalized populations such as LGBTQ+ communities and those living with HIV.
- Support increased public and private funding for mpox research, education, vaccination distribution, and long-term patient care, ensuring equitable access and addressing barriers to health care for at-risk populations.
- Encourage coordinated national and international efforts to address mpox, including global surveillance, resource sharing, research and outreach programs that enhance public knowledge of mpox transmission, prevention, and vaccine effectiveness, particularly in resource-constrained settings.
- Call for improved response by the Department of Health and Human Services to mpox outbreaks, addressing the failures identified in the Government Accountability Office report, including enhanced communication, distribution of vaccines and testing, and collaboration with local leaders.
Delegates also directed the AMA to “advocate for the inclusion of community-driven, culturally competent prevention efforts and educational campaigns to reduce stigma, improve quality of life, and promote health equity for those disproportionately affected by mpox.”
Visit the AMA’s mpox resource center for updates on the disease as well as access to clinical information and resources. The disease, first known as monkeypox, was renamed in 2022 by the World Health Organization.
Read about the other highlights from the 2024 AMA Interim Meeting.
