COVID-19: In Amb. Birx, the White House gets a scientist, physician, public health expert and global health realist as response coordinator

If the criteria for the selection announced Wednesday night of Vice President Mike Pence to lead the U.S. efforts to contain the spread of COVID-19 seemed less than obvious to public health experts, another appointment announced today may bring a measure of reassurance.

Mr. Pence faced criticism in his most prominent previous role in a public health response which involved a opioid-use driven HIV epidemic in Scott County, Indiana. Then, in the absence of a sterile syringe program and of nearby HIV testing as well as of sexual health services, new HIV infections spread by shared needles exploded into the largest such epidemic ever seen in the United States, before then-Governor Pence approved the access to safe injecting equipment that critics said was long overdue.

Ambassador Deborah Birx, the physician scientist global AIDS leader named by the Vice President's office today to coordinate U.S. coronavirus response efforts, has had more success in the public health arena, following data. She has applied that data to science-driven responses over six years of heading the U.S. President's Emergency Plan for AIDS Relief efforts that have turned the trajectory of HIV epidemics worldwide. Named to that post after a career that included the leadership of the U.S. Military HIV Research Program, she oversaw the development of the first -- and only -- vaccine candidate ever to show potential protectiveness against HIV. In the course of that work she also broadened that program's role by bringing antiretroviral treatment to HIV prevention clinical trial sites. 

Leading the U.S. Centers for Disease Control and Prevention's Global AIDS Program when she was nominated to be ambassador-at-large for U.S. global leadership of AIDS responses, she laid out a plan that included strengthening partner country’s capacities and systems, and working with civil society to make sure those voices are involved in decision-making, implementation, and oversight activities, collaborating with community and multilateral partners that would include the  World Health Organization, and promising transparency and accountability. She was confirmed by a unanimous Senate vote.

Under her watch, PEPFAR was named "most improved" for information sharing in the Aid Transparency Index, launched human rights based initiatives to open access to essential services for young women and girls, pediatric patients, men who have sex with men and other marginalized populations. In recent years she has seen percents of diagnosed, treated and virally suppressed individuals in the hardest hit countries near and in some cases exceed, targets that will have to be reached to end the global public health threat of HIV.

If her appointment to this new role brings confidence, it also brings concern about the work that continues to control HIV globally, although, the announcement today says, she "will continue to oversee this critical work," through a deputy. For more, see Science Speaks coverage of Amb. Birx since 2014.