Tribal health leaders say federal authorities are not treating syphilis outbreak as a public health emergency – Alaska Beacon

Natalie Holt sees reminders of the devastating toll of South Dakota's multi-year syphilis epidemic almost everywhere she goes. Desperate to stop the spread of the devastating disease, public health officials are broadcasting extensive messages on billboards and television urging South Dakota residents to get tested.

Holt works as a doctor in Aberdeen, a city of about 28,000 people surrounded by ocean prairie water, and in the Great Plains Area, one of 12 regional divisions of the federal agency responsible for providing health care to Native Americans. -Works as Chief Medical Officer for the Indian Health Service. Americans and Alaska Natives of the United States

The response to this public health issue is not that different from the response to the coronavirus pandemic, she said. Federal, state, local and tribal entities will need to “divide and conquer” as they work to test and treat the population. But the government is responding to the crisis with fewer resources because federal authorities have not declared a public health emergency.

The public plea for testing is part of health officials' efforts to contain the outbreak, which has disproportionately affected Native Americans in the Great Plains and Southwest. According to the Great Plains Tribal Epidemiology CenterSyphilis rates among Native Americans in the region jumped 1,865% from 2020 to 2022, more than 10 times the 154% increase seen nationally during the same period. The Epidemiology Center's region spans Iowa, Nebraska, North Dakota, and South Dakota. The center also found that 1 in 40 American Indian and Alaska Native babies born in the region in 2022 was infected with syphilis.

The rise in cases accelerated in 2021, putting public health leaders still reeling from the coronavirus pandemic into a corner.

Three years later, the outbreak is still going strong, with the number of new infections so far this year 10 times the 12-month total recorded in the years before the surge. And tribal health leaders say their calls for federal authorities to declare a public health emergency have fallen on deaf ears.

The petition seeking support from local and regional tribal health leaders like Megan Currie O'Connell, public health director for the Great Plains Tribal Leadership Health Council and a Cherokee Nation member, is a national A September letter from the Board of Health read: A nonprofit organization based in Washington, DC that advocates for tribal healthcare in the United States. Make a public request to the Department of Health and Human Services Declaring a public health emergency. Tribal leaders said they need federal resources, including public health workers, access to data and national stockpiles, and funding.

According to data from the South Dakota Department of Health. 577 cases of syphilis It was documented in the state this year. Of those, 430 are Native Americans, who account for 75% of the state's syphilis cases, but the group makes up just 9% of the population.

O'Connell said the numbers can be difficult to crunch.

“This is completely preventable and curable. So for this to have happened, something has gone horribly wrong,” she said.

The Great Plains Tribal Leadership Health Committee first called on HHS to: Declaring a public health emergency in February. O'Connell sent a letter outlining some of the resources and training federal agencies have put in place in response to the outbreak, but declared a state of emergency and the substantial resources the board requested. He said he was unable to provide any. The committee's months-old appeal for resources was similar to one made recently by India's National Health Commission.

“We know how to deal with this, but we need additional support and resources to do it,” she said.

Syphilis is a sexually transmitted disease that, if left untreated, can cause life-threatening damage to the heart, brain, and other organs. Women who become infected during pregnancy can pass the disease on to their babies. These infections of newborns, called congenital syphilis, kill dozens of infants each year and can have devastating health effects on others.

Holt said the Indian Health Service facilities she oversees average more than 1,300 syphilis tests each month. He said the recent decline in the number of new infections detected each month, from 92 in January to 29 in September, could be a sign that the situation is improving. Ta. However, a lot of damage has occurred in the last few years.

Cases of congenital syphilis nationwide have more than tripled in recent years, according to the Centers for Disease Control and Prevention. In 2022, 3,700 cases reported — Most in a single year since 1994.

The highest rate of primary and secondary syphilis cases reported in 2022 was among non-Hispanic American Indians or Alaska Natives, at 67 cases per 100,000 people. According to CDC data.

O'Connell and other tribal leaders said they lack the resources needed to respond to the outbreak.

Chief William Smith, vice chairman of the Valdez Indian Tribe of Alaska and chairman of the National Indian Health Commission, called on HHS to provide additional support from the federal government to help tribal health systems better respond to public health threats. Investment is needed, the group said in its letter.

HHS Deputy Assistant Secretary for Public Affairs Rafael Benavides said the agency received the letter sent in early September and will respond directly to the authors.

“HHS is committed to addressing the urgent syphilis crisis in American Indian and Alaska Native communities and supporting the efforts of tribal leaders to mobilize and raise awareness to address this important public health crisis. '' he said.

Federal officials from the Department of Health and CDC A task force has been formed and hosted workshops for tribes on how to respond to outbreaks. But tribal leaders say a public health emergency is needed above all else.

Holt said while the number of new cases appears to be decreasing, authorities are continuing to use the resources they have to combat further spread. But hurdles remain, including convincing people without symptoms to get tested for syphilis. To make this easy, no reservations are required. When people pick up their medication at the pharmacy, they receive a leaflet about syphilis and information about when and where they can get tested.

Despite this “all court reporter” approach, Holt said, officials know that some people frequently don't seek medical care and don't succeed.

O'Connell said the ongoing outbreak is a prime example of why public health agencies need to have staffing, funding, data access and other resources in place before an emergency occurs so they can respond immediately. He said that.

“While our request is specific to this outbreak, it is actually necessary as a foundation for what comes next,” she said. “Because something happens next.”

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this article It first appeared KFF Health News Published November 7 and republished here under a Creative Commons license.