Racial disparities persist in response to the monkeypox outbreak as the numbers of Black and Latino men contracting the disease are now disproportionately high, but that inequity is getting new attention as overall cases drop.

Although overall new cases in the monkeypox outbreak are steadily on the decline after numbers peaked in the summer, a growing share of the continuing numbers belong to men who have sex with men who are racial minorities.

The latest numbers show the racial disparity dramatically. In the week of Sept. 4, Black people consisted of 41 percent of the cases and Latinos consisted of 27 percent, while 26 percent were white and three percent were Asian, according to data from the Centers for Disease Control.

Black people among the new cases of monkeypox were much smaller when numbers were first reported earlier in the summer. For example, the percentage was 18 on June 22 and as low as 8 percent June 8. The percentage of Latinos, as with white people, has been on the decline, although they’re still overrepresented in new cases in the context of their demographics in the U.S. population at large.

The disproportionate impact of new monkeypox cases on racial minorities hasn’t gone unnoticed. As a result, health officials are attempting to shift the focus of the monkeypox outbreak away from gay and bisexual men and other men who have sex with men more broadly and more toward men of color who are sexual minorities.

Sean Cahill, director of health policy research at the Boston-based Fenway Institute, said in an interview with the Washington Blade the racial disparities in the monkeypox outbreak are largely the result of Black and Latino men being “less likely to get vaccinated than their proportion of the population.”

“So they’re more vulnerable to monkeypox, and they’re less likely to get the vaccine,” Cahill said. “So that’s a real problem, and it’s really critical that you know, federal, state and local partners come together and really center equity in the response and try to reduce the burden on Black and Latino gay men, but also increase access to the vaccine to ensure that people can protect themselves.”

The Fenway Institute last week issued a blueprint calling for a more effective federal response to monkeypox, accusing the U.S. government of failing to effectively mobilize existing public health infrastructure to aid communities affected by the virus. The document outlines a range of possible actions, but also concludes marginalized communities are having difficulty accessing vaccines and treatments, which are concentrated at well-resourced institutions less accessible to communities of color.

Cahill, asked to characterize whether the numbers demonstrating racial disparity have changed over time or have remained stagnant, said any trends are difficult to determine because the data on racial demographics has been available only recently and “it’s very imperfect data.”

“I don’t know if it’s getting worse or better, the disproportionate racial ethnic impact,” Cahill said. “But it’s definitely there, and it doesn’t seem to be going away.”

The Biden administration, while touting the 20 percent decline in overall cases in the monkeypox outbreak, has also started to recognize the continued disproportionate impact of monkeypox on Black and Latino men who have sex with men.

Rochelle Walensky, director for the Centers for Disease Control & Prevention, said during a conference call with reporters the U.S. government approaches the decline with “cautious optimism.”

“Over the past several weeks, we have also seen the racial and ethnic makeup of this outbreak evolve,” Walensky said. “While monkeypox cases were first seen predominantly in non-Hispanic white men, in the last week, among the cases for which we have race and ethnicity data, non-Hispanic Black men represented 38 percent of cases, Latino or Hispanic men represented 25 percent of cases, and non-Hispanic white men represented 26 percent of cases.”

Among the efforts the Biden administration has undertaken is a pilot program for vaccines reserved for large events and equity. Monkeypox vaccines have been administered to more than 10,000 people, including at Southern Decadence in New Orleans, Atlanta Black Gay Pride, Charlotte Pride, Boise Pride Festival, and Oakland Pride and Pridefest.

Demetre Daskalakis, the face of LGBTQ outreach for the Biden administration in monkeypox efforts and deputy director the White House monkeypox task force, was among those promoting the pilot program in equity efforts during a conference call with reporters.

“Health departments will use their local experience and connection to the community to identify hyperlocal strategies to improve vaccine access to communities of color, specifically those that are overrepresented in this outbreak,” Daskalakis said.

David Johns, executive director of the National Black Justice Coalition, said in the racial disparities in the monkeypox outbreak are consistent with other trends in public health.

“There have been so many opportunities to learn ways to address health inequities before they grow,” Johns said. “That Black people continue to be disproportionately impacted by this newest health epidemic is additional evidence of how white supremacy works and the importance of democratized responses to crises.”

Biden health officials, asked by the Washington Blade during the virtual meeting why the administration’s stated goal of equity in managing the monkeypox outbreak isn’t producing racial equity among new cases, restated their efforts and talked about the difficulty in achieving that goal.

Walensky, who has also had a lead role in the Biden administration combating the coronavirus pandemic, said racial disparities in the monkeypox outbreak “is not uncommon for many infectious diseases, quite unfortunately,” and defended the U.S. government’s approach to monkeypox.

“And it is exactly for these reasons why we started on these pilot projects before we even saw the shifts in data, as that is often the case in infectious diseases that we have more vulnerable population — racial and ethnic minorities — who are most impacted later on,” Walensky added. “And so, we anticipated this. We have embarked on these activities to address this in exactly this moment.”

Daskalakis, following up in defense of the Biden administration’s efforts on equity, said he’s “spoken to providers on the ground and also promoters at these events who have noted that this effort is really unprecedented in terms of reaching deeply into these communities.”

“I think all of our commitment in the administration is to really focus efforts on equity to resolve the issues that we’re seeing. It is a hard effort and it’s a challenge,” Daskalakis added. “And I think that the way to address equity is intentionally, and this is an example of intentional work to address equity.”

With the racial disparity in the monkeypox outbreak ongoing, health observers say additional efforts are needed to reach out to marginalized communities to ensure they have access to public messaging and vaccinations.

Cahill said although people of color in urban areas go to LGBTQ centers to receive health care, many of them are also getting care through other facilities that aren’t LGBTQ-specific, such as emergency rooms and urgent care clinics .

“I think providing some training and technical assistance to those healthcare organizations in how to provide affirming care to bisexual men could be an important approach and could make it so that people might be more likely to disclose same-sex behavior in those contexts,” Cahill said.