Conservative and progressive media alike are asking what's behind the firing of AIDS Relief Chief Dr. Mark Dybul, an openly gay man.

Dybul headed the President's Emergency Plan for AIDS Relief, PEPFAR. He was appointed to the job, which carries the status of ambassador, in 2006 by President George W. Bush, replacing Randall L. Tobias who served since 2003.

The Washington Post is reporting that Dybul had originally accepted a then President-elect Barack Obama transition team offer to stay for “several months,” but was suddenly pushed out the day after the president's inauguration.

PEPFAR remains a political hot potato. Conservatives and evangelicals like to call the program Bush's greatest success, but HIV prevention experts have long disagreed. Several say the program has actually increased the number of HIV cases worldwide.

The post remains officially under the control of the State Department, but analysts agree the firing came before Hillary Clinton assumed control, leaving most to suggest the call to resign came from the White House.

PEPFAR has distributed life-saving antiretroviral drugs to more than 2.1 million men, women and children in fifteen focus countries decimated by the AIDS pandemic, twelve of which are in Africa.

Critics, however, say the money – Congress just pledged $48 billion – was not well spent. They point out that only 20% of the budget is used for prevention and of that one-third to one-half (the figure varied between authorizations) must be used for abstinence-only programs lauded by social conservatives. It funds neither clean needle exchange programs for IV drug users, nor AIDS prevention programs targeted at sex workers, two of the largest at-risk groups.

“PEPFAR will almost certainly lead to more HIV infection in Africa, not less,” former UNAIDS epidemiologist Elizabeth Pisani wrote at her blog “A full half of the prevention money (some five billion dollars in all) must be spent telling kids to cross their legs, even though we know that abstinence programs don't work.”

A defensive op-ed in Friday's San Francisco Chronicle said Dybul had been “scapegoated for the marginal portions of the Bush AIDS initiative such as emphasis on sexual abstinence and a ban on aiding prostitutes.”

“These are intemperate charges that miss the big picture: a conservative in the White House that woke up to a global scourge and actually did something,” the paper wrote.

PEPFAR's political fire is not confined to how the money is spent, but also who's influencing those decisions. Rev. Rick Warren, the evangelical pastor who found himself at odds with the gay and lesbian community after he likened gay marriage to an incestuous relationship and supported a gay marriage ban in California, had worked closely with Bush administration officials on AIDS prevention in Africa. And ardent anti-gay former Senator Jesse Helms was on board with the goals of PEPFAR.

AIDS itself remains greatly stigmatized, even more so in Africa where conservative lawmakers have used the AIDS pandemic to rationalize dogmatic legislation aimed at marginalizing gays, despite a glut of research that proves heterosexual sex remains the major conduit for HIV transmission on the continent. Lawmakers supporting a bill in the Nigerian Assembly that would criminalize a gay or lesbian couple living together say it is necessary to break the links between “sodomy” and AIDS.

Oddly, The Washington Post is unable to grasp the political implications at hand. It wrote about the job: “[T]he AIDS coordinator is not a typical political job, distributed as spoils, like some deputy assistant position at the Commerce Department. It involves directing a massive emergency operation to provide lifesaving drugs, through complex logistics, to some of the most distant places on Eart.” And it called the firing a “hit-and-run attack” prompted by an administration held captive to “extreme interests.”

Millions of lives are at stake, for sure, but whether Dybul was a political scapegoat or a victim of his own politics remains to be seen.