AIDS Advocates Call for Open Process For Global AIDS Administrator
WASHINGTON, 28 January 2009: Concerned about the next phase of leadership on US Global AIDS programs, representatives of the global AIDS community are calling on the Obama Administration to establish an open process to determine who gets appointed as the next Global AIDS Coordinator.
The next Coordinator will oversee the Presidents Emergency Plan for AIDS Relief (PEPFAR) in the Obama Administration, and will have purview over all funding and policies concerning global AIDS flowing through the State Department, USAID, Health and Human Services, and country-level missions.
The PEPFAR reauthorization bill, passed last spring, allows for spending of up to 48 billion US dollar on US global AIDS prevention, treatment, and care, though these funds have yet to be appropriated.
Notwithstanding the amount of money ultimately allocated to PEPFAR, this is a huge and wide-ranging effort with funding going to over 100 countries, a vast network of programs and a large organizational footprint.
The task for the Coordinator will not be easy, as much because it requires a deep understanding of public health, human rights, and the effects of social, cultural and economic disparities in the spread of HIV.
In a letter to Secretary of State Hillary Clinton, the groups state:
“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 an 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.”
While the majority of organizations have greeted the departure of Mark Dybul with relief, many worry that a rush to replace him may result in the rapid choice of a candidate who is more political appointee than merit-based leader with the vision necessary both to fix problems with and to lead PEPFAR in new directions.
These groups, representing a diverse array of both domestic and international organizations, are seeking an open and participatory selection process modeled on similar efforts undertaken by the US National Institutes of Health and by the Global Fund.
“As you know,” states the letter to Clinton:
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).
In an editorial published Monday, the British public health and medical journal, The Lancet, also called for a merit-based appointment through a similar process, stating:
“The incoming Coordinator should be chosen based on his experience and ability to do the job. Essential credentials for the position include: bold and visionary leadership and expertise in global health at the scientific, policy, and implementation levels; high-level global management experience in collaboration with political, technical, and civil society groups and those living with HIV/AIDS; a commitment to increase coordination with other HIV/AIDS donors, the private sector, and foundations; a proven track record of making ambitious decisions independent of political or special interest considerations; and a commitment to do more to integrate disease-specific responses with health systems strengthening.”
Unfortunately, as one commentor wryly noted, the Lancet used only the pronoun “he,” implying perhaps inadvertantly that only men should be considered for the job. In fact, the 3 current candidates whose names are most frequently mentioned are all men.
Earlier recommendations for a similar process submitted to the Obama transition team apparently were apparently not adopted because to date the State Department has not indicated it will in fact convene a selection panel.
Sources close to Secretary Clinton have suggested that putting forth specific candidates now would be a more effective route for community participation.
“Recommendations for candidates with widespread support in the community would likely ensure both a smoother transition and increase the likelihood that all parties will be happy,” said one source. Some contacts noted that given how presidential appointments tend to work, “This would seem a more practical approach than requesting a new process.”
Virtually all US-based advocacy groups working on global AIDS policy agree new directions in PEPFAR policy and programs are needed, but not everyone emphasizes the same priorities or has the same skill-set at the top of their list for a new Coordinator.
Kilde: The Push Journal
