President Obama's nomination of Dr.
Eric Goosby to serve as Global Coordinator for U.S. AIDS policy has won high
marks from AIDS funding advocates for his wide experience at home and
overseas. David Bryden of the Center for Global
Health Policy notes that time
spent in Africa has given Dr. Goosby a strong grasp of the big policy picture
needed to guide controversial AIDS prevention issues, lower infection rates,
and save millions of lives.
"They've chosen someone with
a lot of experience, not only in HIV/AIDS policy, but in actual implementation
of HIV/AIDS programs, from Rwanda to eastern Europe. So it's a very exciting choice as far as
we're concerned," he said.
Goosby's more than 25 years in combating HIV/AIDS ranges from his early years
treating patients at California's San Francisco General Hospital to his
service in the Clinton administration
as Deputy Director of the National AIDS Policy Office and Director of HIV/AIDS
Policy in the Department of Health and Human Services (HHS). He also coordinated campaigns in Asia and, as
Bryden notes, in Rwanda and in southern Africa, and favors an approach that
integrates HIV treatment with measures against other life-threatening
infectious diseases like malaria and tuberculosis that often occur alongside
AIDS and further jeopardize patients' chances of survival.
"He had worked to develop
treatment programs in Rwanda and in a number of other countries. He's looked particularly at a situation in
southern Africa as well in terms of the needs of people, refugees in
particular, coming from Zimbabwe. He's
just done a lot of work that comes to looking at how to improve U.S. investments
in health systems and better integrate HIV care with tuberculosis care, which
is really, really important, because those two things really need to go
together," he pointed out.
year's hard-fought efforts by Congress and the Bush administration succeeded in
hammering out a coherent funding strategy that emerged as an estimated $48-50
million package for HIV/AIDS over the next five years. As the chief adviser for the President's
Emergency Plan For AIDS Relief (PEPFAR), Goosby will play a major role in next
year's appropriations process, which attempts to blend and resolve highly
divergent approaches of American researchers, civic groups, medical
professionals, and religious groups, some of them with deeply held convictions and
moral reservations, about methods of AIDS treatment and prevention.
the 2008 election campaign and its aftermath, much of the previous year's
combat over funding was put aside to make way for a new president with the discretion
to formulate his own funding strategies in future budget encounters with
Congress. David Bryden says the
reception of President Barack Obama's choice of Eric Goosby has so far been quite positive from a wide variety of groups because they are enthusiastic
about Goosby's high level of experience.
Bryden cautions, however, that not enough has been achieved during
President Obama's first 100 days in office to indicate a clear direction in
which US AIDS policy is going.
biggest question mark hanging over the program, I think, is how much money will
be allocated for it because President Obama during the campaign promised an
additional $1 billion per year. And
that's really needed because the legislation was changed, and the program has a
broader mandate. And so it's really
going to need greater funding in order to carry out that mandate – and not only
on HIV/AIDS, but also to make sure that health systems are strengthened as we
fight HIV/AIDS," notes Bryden.
says details of the president's budgeting priorities for AIDS should emerge
over the next few weeks, as congressional lawmakers and the president work out
their differences to formulate US funding for the 2010 fiscal year. Up until this week's designation of Dr.
Goosby to serve as the president's PEPFAR point man, it has been unclear where
U.S. policy on AIDS is heading.
program, I think, in terms of HIV/AIDS, has been in a kind of holding pattern,
unfortunately, while President Obama has tried to select this official. So I feel that there has been some time lost,
unfortunately, in terms of getting the program going and maintaining the
momentum. In terms of collaboration with
private organizations, I think it's too early to say. But we haven't seen much talk about HIV/AIDS
from the administration or much action for that matter in terms of maintaining
the level of commitment and the momentum in the program," he observed.
Global AIDS Coordinator job is an ambassadorial rank position for which Eric
Goosby much be approved by Congress during confirmation hearings, which are
expected to proceed over the next few weeks.
It also calls attention to what critics say is the Obama
administration's slow pace of filling vacancies in key government health
positions. Congressional confirmation of
Kathleen Sebelius' nomination to serve as Secretary of Health and Human
Services was finalized on Tuesday, just before the conclusion of the
president's first 100 days. The vacant
HHS position was quite noticeable earlier this week, when the administration
designated Homeland Security Secretary Janet Napolitano to be its point person
in combating a deadly swine flu threat to U.S. communities. The swine flu crisis also revealed another
prominent unfilled vacancy, the appointment of the chief of the Atlanta,
Georgia-based Centers for Disease Control and Prevention (CDC).
"We really haven't seen much action in
getting these key officials in place.
This is the first sign that we've seen of the kind of commitment that
the president talked about on the campaign trail, so we're hoping that Dr.
Goosby can put this program forward in a bold way and get the funding that he
needs to implement it," said Bryden, who also voiced the hope that the national
economic crisis would not compel the Obama administration to shift budgeting
priorities away from the money Congress and the president want to commit for
HIV/AIDS research and other public and private AIDS initiatives.