Senate Foreign Relations Committee Unanimously Approves Randall Tobias To Head Global AIDS Initiative
The Senate Foreign Relations Committee on Thursday unanimously approved the nomination of former Eli Lilly CEO Randall Tobias to head the new State Department office created under the global AIDS initiative, the Indianapolis Star reports (Indianapolis Star, 10/3). President Bush on July 2 nominated Tobias to head the new Office of the Global AIDS Coordinator created under the five-year, $15 billion global AIDS initiative. As coordinator, Tobias would work under the secretary of state, and he would be able to distribute funds directly to nongovernmental organizations and transfer funds between government agencies. The position will carry the rank of ambassador. The new office will oversee U.S. international assistance in the fight against HIV/AIDS and coordinate the activities of the various agencies and departments that will deliver the aid (Kaiser Daily HIV/AIDS Report, 10/1). Bush has praised Tobias for his management skills, according to the Star. Some advocates have raised concerns about Tobias' links to the pharmaceutical industry, saying that he could avoid promoting affordable access to antiretroviral drugs in order to protect the profits of drug makers, the Star reports (Indianapolis Star, 10/3). However, during his confirmation hearing on Tuesday, Tobias said he will represent the interests of the United States and employ the most cost-effective methods to help HIV/AIDS patients throughout the world. "I'm hopeful my experience in the pharmaceutical industry might enable me to get a better deal," Tobias said. He said that he supports Bush's plan to direct most of the funding for global AIDS initiative projects through U.S. programs instead of through the Global Fund to Fight AIDS, Tuberculosis and Malaria. Tobias also said that the primary obstacle to implementing an antiretroviral program in sub-Saharan Africa is a lack of infrastructure, not the lack of available drugs or funds(Kaiser Daily HIV/AIDS Report, 10/1). The full Senate could vote on the nomination on Friday (Indianapolis Star, 10/3).
Advocates Oppose Nomination
Several AIDS advocacy groups on Thursday sent a joint letter opposing Tobias' nomination to the senators on the Foreign Relations Committee. The letter, which was signed by Africa Action, Advocates for Youth, AIDS Policy Project, Artists Against AIDS Worldwide, Center for Health and Gender Equity, Global AIDS Alliance, Health GAP, Keep a Child Alive, Progressive National Baptist Convention, Student Global AIDS Campaign and Washington Office on Africa, says that Tobias is "not the appropriate person" to serve as coordinator because he has "virtually no significant experience working in the field of public health or in the effort to combat AIDS." In addition, Tobias' experience as an executive at a pharmaceutical company "raises serious questions of conflict of interest" in terms of drug procurement, the letter says. Tobias is not divesting his stock in Lilly, which is a member of the pharmaceutical trade association that has "worked tirelessly to block" access to antiretroviral drugs in the developing world, according to the letter. Finally, Tobias' testimony at his confirmation hearing, including his argument that the Global Fund cannot effectively utilize additional funds and his rejection of comprehensive HIV prevention strategies in favor of abstinence-only education, "raises serious questions about his fitness" to serve as AIDS coordinator, the letter says (Letter text, 10/2).
Opinion Piece Offers Alternative 10-Step Plan
Sen. Lamar Alexander (R-Tenn.) might have "come up with another wish list if female senators" had gone on the trip that Alexander and other Republican senators took to Africa, Adrienne Germain, president of the International Women's Health Coalition, writes in a Washington Times letter to the editor responding to a 10-step plan for Tobias laid out in a recent Times opinion piece by Alexander. Germain offers the following alternative suggestions to Tobias:
- Go to Africa and ask why women and girls account for 60% of HIV-positive people.
- Support economic opportunities for women and girls to curb the practice of trading sex for food, school fees or shelter.
- Encourage responsible behavior in men and boys, including an end to sexual violence and coercion.
- Ensure that health organizations provide accurate information about HIV prevention, including condom usage.
- Provide comprehensive sexual education.
- Provide treatment for HIV-positive parents to curb the growing orphan problem.
- Restore funding to the United Nations Population Fund.
- Eliminate the so-called "global gag rule," which prohibits U.S. funding from going to organizations that counsel women about abortion and destroys women's health services, according to Germain.
- Provide support for women who provide most of the care for orphaned children and sick adults.
- Improve health care infrastructure to ensure the availability of sexual and reproductive health services, in addition to HIV testing, care and treatment (Germain, Washington Times, 10/3).