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In September 2024, PrEP4All released “HIV Activism and US Biosecurity: An After-Action Report on the 2022 Global Mpox Crisis.” Funded by amfAR and based on in-depth interviews, a national survey and PrEP4All’s experience in collaboratively activating a community response, this report provides a detailed analysis of how HIV activists and frontline providers played a crucial role in mobilizing an effective, rights-based response to the mpox outbreak that started in the US in May 2022. 

The report clearly shows that the US-based HIV infrastructure of activists, advocates, providers and Ryan White clinics was essential to catalyzing local and federal action at every stage of the outbreak, which led the US government to declare a public health emergency from August 2022 to January 2023. 

The report calls for concrete action to: 

1. Maintain and systematize communications channels between government and impacted communities to respond to outbreaks and share information on a regular basis. 
2. Recognize and resource LGBTQI+, BIPOC and HIV-focused service providers, community organizations and activist groups as key partners in domestic biosecurity and preparedness. 
3. Promote prevention equity through a national PrEP Program that could be a cornerstone for rapid scale up of vaccines and tests for other outbreaks, including mpox. 

This report comes in the context of a global Public health emergency of international concern (Pheic) for mpox, as defined by the World Health Organization. The Pheic is based on the ongoing and expanding outbreak in sub-Saharan Africa, centered in the Democratic Republic of the Congo and including many countries in the region. This outbreak, like the global outbreak, includes sexual transmission of mpox impacting gay men and other men who have sex with men, as well as sex workers. It is also impacting children, health workers, displaced people and cisgender pregnant women–among others. 

The report also comes at a time when PrEP4All and other advocates are concerned about our domestic preparedness for a resurgence, particularly in terms of vaccine access for un- and underinsured populations. Read our recent letter to the Biden Administration here. 

The document has a domestic focus with international implications and resonance. We cannot prepare for or respond to outbreaks of any kind without intention and investment directed to the HIV infrastructure of activism, providers and clinics that has been painstakingly built by and for people living with and at risk of HIV over the past decades. Funding for this work is crucial both for the ongoing HIV fight and for future biosecurity work.

PrEP4All thanks amfAR for its support in developing this report, stands in solidarity with the activists and providers mobilizing to respond to the current emergency in Africa, and seeks collaborators interested in discussing this after-action report and translating its findings into concrete, catalytic HIV activism.