Co-Signatory Portal

We are united in calling for urgent action to prevent Monkeypox (MPX) becoming endemic in the UK.

Since May 2022, the UK MPX outbreak has become a crisis; with case numbers rising steeply, clinics are overwhelmed. MPX can be highly infectious through close contact, requiring people to isolate.  Although the outbreak was unexpected, public health strategies have failed.

We need urgent action, now, to eliminate MPX in the UK. Allowing MPX to become endemic risks harming the health of our population and exacerbating the health inequalities experienced by gay and bisexual men and other men who have sex with men.

We need urgent action:
  • System-wide coordination with clear lines of accountability.
  • Funding to achieve outbreak control, optimise MPX care, protect existing sexual health services and support people required to isolate.
  • An appropriately resourced vaccine programme with a clear delivery plan.

Serious risk to health
  • Pressures from MPX are growing daily. 1,552[1] cases have been diagnosed in the UK just two months.
  • Delays in MPX diagnosis risks further transmission and harm to individuals.
  • MPX has destabilised services for sexually transmitted infections (STIs), HIV pre-exposure prophylaxis (PrEP) and long-acting reversible contraception (LARC) with many services reporting significant reductions in non-MPX activity and some describing 90% reduction in PrEP and LARC access.[2]
  • Delayed access to STI treatments increases transmission and the risk of antibiotic resistance.
  • Reduced access to PrEP and HIV testing risks the UK not meeting HIV Action Plan targets.
  • MPX risks moving from level 2 (transmission within a defined sub-population with high number of close contacts) to level 3 (transmission within multiple sub-populations or larger sub-populations). Whilst, so far, all of those affected in the current outbreak have recovered, the risk of severe illness or death is higher in young children and pregnant women – wider population transmission will yield avoidable harm.
Lack of resources
  • Demand on sexual health services was already high. Managing MPX adds significant burden with additional time required for assessing patients and applying infection control.
  • MPX management is being delivered by local sexual health systems without additional funding or staffing.  
  • Individuals diagnosed with MPX are required to self-isolate, sometimes for long periods, with no financial or practical support. This can result in stigma, mental ill-health, loss of work, and other hardship. For people in vulnerable circumstances (shared housing, sex work), or with unsupportive employers, this can be devastating.
Inadequate vaccine access
  • The current vaccination roll-out is too slow; vaccine access is hampered by lack of co-ordination between the agencies responsible for different parts of the system.
  • There are insufficient numbers of vaccines, too few men have been vaccinated, and communication about vaccine to affected communities has been poor.
  • We have seen no plans for how, or when, suboptimal access to vaccines will be resolved.
Lack of coordination and accountability
  • No-one is currently responsible for whether MPX is controlled. No-one is accountable for setting and meeting targets to reduce infections.
  • At present there are multiple parallel and overlapping meetings. Some of these have no clear terms of reference. They have unclear powers and no clear accountability.
  • Not all key stakeholders are involved in developing response strategy and planning.
  • There is lack of detailed information about case severity and risk factors. This limits our ability to provide clea