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It was 2022 when pediatrician Tom Herr realized just how many babies on the Rosebud reservation in South Dakota were already infected with syphilis when they took their first breaths. He was seeing more and more patients who’d spent their first weeks in a tangle of tubes that pumped antibiotics into their tiny bodies. Some had died in the womb.

This story was originally published by ProPublica.

With growing alarm, Herr and other health officials spread the word, appealing to bosses at the federal Indian Health Service and tribal health authorities, writing op-eds and talking to reporters. But as the months ticked by, the crisis mounted.

By 2023, an astonishing 3% of all Native American babies born in South Dakota were infected.

Now, according to tribal leaders, the syphilis rate among American Indians and Alaska Natives in the Great Plains surpasses any recorded rate in the United States since 1941, when it was discovered that penicillin could treat the infection.

On a map of rising syphilis cases nationwide, some reservations stand out like a red alert.

Desperate for help, in late February of this year tribal leaders from four Great Plains states took the extreme step of asking U.S. Department of Health and Human Services Secretary Xavier Becerra to declare a public health emergency. The Great Plains Tribal Leaders’ Health Board asked the secretary to deploy commissioned officers from the U.S. Public Health Service to help diagnose and treat people for syphilis, and to provide emergency funding for the tribes to improve their response capabilities.

More than 10 weeks later, Becerra has not responded.

“We need to free up resources so we can take extraordinary measures to respond to these extraordinary circumstances,” said Meghan Curry O’Connell, chief public health officer for the tribal health board.

Syphilis, which is transmitted primarily through sexual intercourse, is easily treatable. But the disease is life-threatening when left unchecked. Babies infected in the womb can be born in excruciating pain, with deformed bones, brain damage or other serious complications. They can even die.

The emergency declaration may be the only way to get money in time to prevent more babies from getting sick or dying. The typical funding processes — which go through the federal budget or the Centers for Disease Control and Prevention — can lead to a delay of a year or more before money trickles down to communities.

In response to questions from ProPublica about why Becerra hasn’t replied to the emergency request, an HHS spokesperson wrote that “HHS has received the request and will respond directly” to the Great Plains tribes, but did not provide a time frame for doing so.

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The Native News Health Desk is made possible by a generous grant from the National Institute for Health Care Management Foundation as well as sponsorship support from the American Dental Association. This grant funding and sponsorship support have no effect on editorial consideration in Native News Online.