A week into the Obama administration and AIDS is making waves behind the scenes. The question of who will be the next Global AIDS Coordinator--heading one of the largest single foreign aid programs in the world--has been occupying many. Just a week ago the Washington Post reported that Ambassador Mark Dybul would stay at the post he has held since taking over from Randall Tobias. But things clearly change quickly in a transition. Activists who fought with the Bush administration over its focus on "Abstinence-Only" HIV prevention programs objected to him staying on and this week word came that President Obama had accepted his resignation after all.
Now the question becomes who will be the next Global AIDS Coordinator? Congress last year reauthorized the President's Emergency Plan for AIDS Relief along with TB and malaria programs at $48 billion--growing the program and beginning to fix some of what has not worked. So much of the work, though, will be up to the next head of the program. Will the Obama administration embrace multilateralism and the Global Fund? Will there be support for real, comprehensive prevention programs that include controversial but effective programs like needle exchange and positive work with sex-workers? Will the US use its billions of dollars to drive down the prices of AIDS drugs worldwide? So much can be changed by a new administration.
The leading contenders for the job (all impressive people) seem to be (according to the Lancet): Jim Yong Kim, former Director of the WHO HIV/AIDS department, founder of Partners in Health, and Chair of the Department of Global Health and Social Medicine at Harvard Medical School; Eric Goosby, former Director of the Office of HIV/AIDS Policy of the US Department of Health and Human Services, and current CEO and chief medical officer of the Pangaea Global AIDS Foundation; and Nils Daulaire, former President and CEO of the Global Health Council.
But a much bigger question has just been posed by the Lancet and a group of about 85 AIDS organizations--who gets to decide who's best qualified? The AIDS activists have sent a letter to Secretary of State Clinton requesting an open search process and a committee to decide that question. And who knows--maybe she'll agree? Maybe some great new name will emerge. I live in DC where my hometown paper gives me regular updates with bold-face names of who's being talked about for what position... but imagine what a different process it would be if this were a bit more open. Imagine candidates out there making the case for how their ideas would put more people on AIDS drugs or promote better prevention programs, and how they would be better at leveraging US AIDS investments to get more from other countries. That would be an amazing change... stay tuned.
Read the full letter with signatories at Global AIDS Alliance's website
The Honorable Hillary Clinton
Secretary of State
Department of State
2201 C St, NW
Washington, DC 20520
26 January 2009
Dear Secretary Clinton,
As you know, US assistance on AIDS is unique in terms of scale and accomplishment. Its connectedness with a complex array of other actors both within U.S. development assistance and with among other bilateral donors and multilateral agencies mean that the Office of the Global AIDS Coordinator is a singularly important appointment.
Therefore we are writing to you as representatives of the AIDS community to request that, instead of immediately moving to fill the position vacated by Ambassador Mark Dybul, you instead pursue a innovative, competitive, merit based process for selection of the next head of OGAC. In an expedited manner, we recommend you convene a multi- stakeholder committee comprising US government representatives, implementers and civil society, to identify top candidates for the position. This selection committee could consider a range critical qualifications, for example, experience implementing HIV prevention and treatment programs and a demonstrated commitment to involving affected communities, including people with HIV, at all levels of program activity.
This committee would work with your office in determining the next OGAC Director. Through such a process, the Administration would back up its refreshing commitment to openness, transparency, and change with concrete action.
As you know, this is the manner in which NIH selected the first and second directors of the Office of AIDS Research (OAR), after the NIH Revitalization Act of 1993. Harold Varmus convened a search committee who reviewed candidates and who selected Bill Paul (in 1994) and later Neal Nathanson (in 1998).
We are confident you could convene a search committee in less than two weeks and that by March that committee could recommend a candidate or candidates to your office.
[signatories removed for space]
cc: Senator John Kerry, Chair, Senate Foreign Relations Committee
Senator Richard G. Lugar
Rahm Emanuel, White House Chief of Staff
Melody Barnes, White House Director of Domestic Policy
Dr. Susan E. Rice, U.S. Ambassador to the United Nations
Tina Chen, Director, Office of Public Liaison
Denis McDonough, Foreign Policy Advisor