As gay men working in medicine, watching the monkeypox virus spread through our community has been devastating.

On July 23 the World Health Organization declared monkeypox a global health emergency. But in New York we’d been seeing the outbreak’s effects for weeks.

Monkeypox is not a novel virus. The infection, which can cause fever, headaches, body aches, fatigue and a painful rash across the body, already has a government-approved vaccine and treatment as well as an established lab test. The scientific community couldn’t have been more primed for an outbreak.

Yet despite our resources and knowledge, U.S. case numbers are multiplying rapidly — going from one case reported in May to more than 2,000 in two months and now approaching 4,000 known cases.

So how did we get here? The answer is simple: Viruses spread fastest among the most marginalized, underserved and under-resourced individuals. Public health interventions often fail to reach these people, further worsening health care disparities and stigma — and enabling larger outbreaks.

It’s no accident that this virus receiving a weak public health response is one that mostly affects men who have sex with men, many of whom self-identify as gay, bisexual and transgender. In fact, WHO advisers declined to declare a monkeypox emergency in June in part because the disease has not moved out of this primary risk group. With cases rising, WHO Director-General Tedros Adhanom Ghebreyesus overruled advisers to make the declaration.

Nothing about LGBTQ individuals makes them more biologically susceptible to monkeypox. The current outbreak is primarily transmitting via close physical and sexual contact, though it can also spread through respiratory secretions and touching infected fabrics.

To end monkeypox, we must confront discrimination in the medical and public health systems that has enabled this preventable crisis. Clearly, having a vaccine for monkeypox is not enough in the face of the homophobia that hampers public health response. And the steps it will take to end monkeypox will also enhance access to the comprehensive, patient-centered primary care that largely does not reach LGBTQ individuals.

Step one is better public health messaging. Officials have balked at focusing on prevention efforts among gay and queer men because they fear any discussion of gay sex will be seen as homophobic. Messaging should embrace harm reduction and communicate ways individuals can avoid infection amid a vaccine shortage.

With decades of experience serving vulnerable communities and protecting their privacy, LGBTQ-focused community health centers are most likely to reach those most at risk for monkeypox. By prioritizing these organizations for vaccine supply and treatment funding, we can strengthen primary care facilities rather than creating pop-up clinics that address only the vaccination.

Indeed, these more robust centers can also tackle the documented health care disparities that harm LGTBQ communities beyond monkeypox. While patients wait for monkeypox vaccines, they should be offered free HIV and STI testing and treatment, referrals to primary care providers who can prescribe PrEP antiviral drugs to prevent HIV infection, and contact information for affordable mental health providers who specialize in LGBTQ issues.

Vaccine sites can distribute other public health tools such as condoms, lubricant, hand sanitizer, masks, fentanyl test strips and Narcan kits. At the same time, other vaccines recommended particularly for men who have sex with men — meningitis, hepatitis B and HPV — should be made available.

We need to confront the health care disparities and systemic prejudices that allowed this disease to become a global emergency.

Eric Kutscher is a primary care and addiction medicine doctor in New York City. Lala Tanmoy Das is an MD-PhD student in New York City.