The next epidemic may be here. The U.S. isn’t ready for it.

For people like me who are working inside the broad national response to monkeypox, there are loud echoes of the earliest days of Covid-19 and, longer ago, of AIDS. But understanding the country’s capacity to contain monkeypox requires an examination of the STI epidemic that the nation has ignored for years, which is why these diseases continue to be out of control.

Consider this: More than 2.5 million sexually transmitted infections were diagnosed in 2020, the last year with complete statistics. The ballooning rates touch people of every race, sexual orientation, and even age. Syphilis among newborns has increased 235% since 2016, and STIs like gonorrhea have reached historic highs among teens and adults.

The lack of accessible testing, combined with stigma, are major factors in the increases. Yet there is no dedicated federal funding to guarantee that communities can provide STI testing.