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[afro-nets] New Coordinator of PEPFAR

  • From: "Sweety Prem Kumar R" <dr.r.sweetypremkumar@gmail.com>
  • Date: Thu, 30 Apr 2009 22:07:14 +0530

Cross-posted from: AIDS Beyond Borders <AIDS-Beyond-Borders@googlegroups.com>

29 April 2009

*With new Coordinator of PEPFAR, some anticipate changes in HIV prevention policy*

The White House announced the nomination of a new Global AIDS Coordinator, head of PEPFAR, the U.S. international AIDS program. He is Dr. Eric Goosby, currently CEO and Chief Medical Officer of Pangaea Global AIDS Foundation, http://www.pgaf.org/. If confirmed by the U.S. Senate, he would replace Ambassador Dr. Mark Dybul, who is now at Georgetown University.

A New York Times article, copied below, hints at possible changes in prevention strategy, with less emphasis on abstinence and fidelity. A number of HIV prevention experts have expressed concern about whether Goosby with his medical orientation would give the priority to prevention necessary to markedly reduce new HIV infections.

Dr. Goosby's bio, taken from the Pangaea website, is also copied below,


A friend of CCIH who has known Dr. Goosby for 20 years commented on the nomination, "My impression is that he is someone of mediocre talent whose main strength has been to have the right political connections......I expect he will try to carry out his new job in the least controversial way possible."

*Obama Picks Leader for AIDS Effort*


Published: April 27, 2009

Dr. Eric Goosby, a pioneer in the fight against AIDS, is President Obama’s choice to run the American effort to combat the disease globally, the White House announced Monday.

The President’s Emergency Plan For AIDS Relief, known as Pepfar, was championed by President George W. Bush. It is expected to spend $48 billion over the next five years and is credited with markedly reducing the disease’s death rate. Its prevention policy has been controversial because of its emphasis on socially conservative methods.

With a new administration and a Democratic majority in the House, organizations seeking prevention choices beyond abstinence and fidelity — including a renewed commitment to distributing condoms — are eager to try to rewrite the guidelines.

Dr. Goosby, 56, will probably become the lightning rod for that fight once he is confirmed by the Senate as the State Department’s global AIDS coordinator and ambassador at large. The doctor, a medical professor at the University of California, San Francisco, has a long career in public health that includes senior posts in the Clinton administration.

He declined to be interviewed, but in acknowledging the appointment, he hinted at his sympathies. “The Pepfar program has already saved millions of lives in sub-Saharan Africa and other hard-hit areas around the world,” Dr. Goosby said in a statement. “But significant challenges relating to the prevention and treatment of H.I.V. remain.”

Supporters of loosening the guidelines want to include family planning programs that they say would give women more options in avoiding AIDS.

“What we have found is that the disproportionate emphasis on abstinence and fidelity has led to the destruction of a comprehensive approach,” said William A. Smith, the vice president for public policy at Siecus, the Sexuality Information and Education Council of the United States.

Those pushing for change point to a recent study that shows that although Pepfar money has made a significant dent in the death rate, the infection rate has remained steady. The study, published this month in the Annals of Internal Medicine, showed that by 2007, four years after Pepfar was organized, AIDS deaths had dropped by 10.5 percent in countries with the program. But infections climbed in all the countries studied.

In the past, maternal health organizations and AIDS organizations have been divided on how to handle financing with stipulations. In recent months, activists said, the Bill and Melinda Gates Foundation has led an attempt to make peace so both camps could press for the same guidelines.

Some guidelines on spending will come from Dr. Goosby, but some policies were written into the law. These included the stipulation that organizations receiving money be able to opt out of aspects they opposed.

Critics said the ability to opt out meant AIDS prevention programs were unbalanced in places where they were run by faith-based organizations.

If the choice of opting out of the program is removed, then Catholic and missionary programs are likely to be discontinued, and millions will be denied health care, said Bill O’Keefe, the spokesman for Catholic Relief Services, which rejects condoms in its prevention programs.

*Dr. Eric Goosby, CEO and Chief Medical Officer *

Eric Goosby, MD has been CEO and Chief Medical Officer of Pangaea Global AIDS Foundation since 2001. He is also Professor of Clinical Medicine at the University of California, San Francisco. Dr. Goosby has played a key role in the development and/or implementation of HIV/AIDS national treatment scale-up plans in Rwanda, South Africa, China, and Ukraine. He has extensive international experience in the development of treatment guidelines for use of antiretroviral therapies, clinical mentoring and training of health professionals, and the design and implementation of local models of care for HIV/AIDS. Dr. Goosby focuses his expertise on the scale-up of sustainable HIV/AIDS treatment capacity, including the delivery of HIV antiretroviral drugs, within existing healthcare systems.

Dr. Goosby has over 25 years of experience with HIV/AIDS. His experience ranges from his early years treating patients at San Francisco General Hospital when AIDS first emerged to engagement at the highest level of policy leadership. During his tenure under the Clinton Administration as deputy director of the White House National AIDS Policy Office and director of the Office of HIV/AIDS Policy of the Department of Health and Human Services, Dr. Goosby managed a $2.5 billion HIV/AIDS care and prevention budget.

A native son of San Francisco, Dr. Goosby was treating patients at San Francisco General Hospital when AIDS first began to take its devastating toll on the City. In 1986, he became AIDS activity division attending physician, and the following year was appointed associate medical director of SF General’s AIDS Clinic. During his tenure, he conceived of a new strategies for the entry and retention of HIV-infected intravenous drug users into HIV clinical care, establishing three medical facilities located in methadone treatment centers. He was also the principal investigator for numerous AIDS Clinical Trial Group Studies

In 1991, Dr. Goosby moved to a position in the federal government as director of HIV Services at the U.S. Public Health Service/Health Resources and Services Administration. In this position, he administered the Ryan White CARE Act, overseeing the distribution of federal funds and the planning of services in 25 AIDS epicenters and all States in the United States and its territories.

In 1994, Dr. Goosby became director of the Office of HIV/AIDS Policy in the Department of Health and Human Services. In this position, he was a strong advocate for responsible government policy in the areas of HIV/AIDS prevention, treatment and research, advised on the federal HIV/AIDS budget, and worked with Congress on all AIDS-related issues.

In 1995, Dr. Goosby saw the need for explicitly defining how to use a new class of drugs, protease inhibitors, to allow for rapid incorporation of these drugs into treatment plans for both infectious disease specialists and more importantly, general practitioners caring for HIV patients. He created and convened the DHHS Panel on Clinical Practices for the Treatment of HIV Infections. This committee defined how to use protease inhibitors in conjunction with already existing antiretrovirals. The committee later expanded its works to address standards of care for antiretroviral use for pediatric patients and pregnant women. Dr. Goosby has remained actively involved in this Panel, now known the DHHS Panel on Antiretroviral Guidelines for Adults and Adolescents, which is widely recognized as defining the standard of care for HIV/AIDS treatment in the United States.

In 1997, while still in his position at HHS, Dr. Goosby also acted as interim director of the National AIDS Policy Office at the White House, reporting directly to the President as his senior advisor on HIV-related issues. In 1998 he helped to foster and orchestrate the dialogue on racial disparities in HIV/AIDS that led to the Minority AIDS Initiative. Dr. Goosby’s office was responsible for guiding the implementation of the Initiative at HHS over the next three years. Dr. Goosby’s office also coordinated scientific reviews of needle exchange as a public health intervention.

In 2000, while working as the director of HIV/AIDS policy at the Department of Health and Human Services, he served as acting deputy director of the National AIDS Policy Office in the White House. In these roles, Dr. Goosby had continuing involvement in the Ryan White CARE Act and its reauthorization, and participated in the definition and creation of a coordinated response to HIV/AIDS in the global setting, which became the LIFE initiative during the Clinton Administration.

Sweety Prem Kumar R