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
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.