Sexual health clinics on the front line of the monkeypox response are already financially stretched, leaving the United States and U.K. ill-equipped to tackle the first major global health test since the COVID-19 pandemic.

Infectious disease experts say sexual health clinics — which offer confidential walk-in diagnosis and treatment — are best placed to identify and treat cases of monkeypox, which is largely affecting men who have sex with men.

Yet such programs are doing so largely without additional funding despite years of financial neglect. There is little data on funding for sexual health services globally, but experts agree that the sector is underresourced.