March 19, 2018

HIV/AIDS researcher emerges as Trump's top pick to lead CDC

Daily Briefing

    The Trump administration is reportedly vetting Robert Redfield, a leading HIV/AIDS researcher and professor at the University of Maryland Medical Center, to lead CDC, according to administration officials who have knowledge of the matter.

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    If appointed, Redfield would replace former CDC Director Brenda Fitzgerald, who resigned from the position earlier this year amid reports that she traded stocks in a tobacco company while in office. Since Fitzgerald's resignation, Anne Schuchat has served as acting CDC director.

    Trump considers candidates for CDC director

    The administration has been considering several candidates to lead CDC since Fitzgerald's resignation, but in the past two weeks Redfield has emerged as Trump's top choice, sources familiar with the matter told the Washington Post's "To Your Health." The administrations intends to announce a choice to lead CDC as early as Tuesday, after vetting is complete, the New York Times reports.

    CDC director is an appointed position that does not require the Senate's confirmation. However, Sen. Patty Murray (D-Wash.)—the ranking member on the Senate Health, Education, Labor, and Pensions Committee—in a letter sent to the White House this month wrote that lawmakers plan to "thoroughly scrutinize" any candidate to ensure the candidate is an "upstanding steward" of public health, "To Your Health" reports. Murray in the letter listed more than 12 criteria the candidate should meet, including experience:

    • Leading a science-based agency;
    • Prioritizing science over ideologies; and
    • Resolving conflicts of interest.

    Redfield's background

    Redfield graduated from Georgetown University and Georgetown University School of Medicine and completed his residency in internal medicine at Walter Reed Army Medical Center. According to "To Your Health," previous Republican administrations have considered Redfield to lead CDC and NIH, though he never was appointed to the positions.

    Redfield is considered a pioneering researcher on HIV/AIDS. He co-founded the Institute of Human Virology, where he is the director of the division of clinical care and research. At the institute, Redfield focuses on clinical research and care for chronic human infections, with a particular focus on HIV/AIDS. According to "To Your Health," Redfield has several years of experience treating individuals who use illicit drugs, such as heroin, with such patients accounting for about half of the HIV/AIDs patients treated at the institute. CDC has awarded the institute more than $138 million in grants to fight HIV/AIDS and other health issues in foreign countries such as Kenya, Nigeria, Tanzania, and Zambia.

    According to "To Your Health," Redfield does not appear to have experience with leading a public government health agency. However, Redfield advised NIH and served on an advisory council on HIV/AIDS during former President George W. Bush's administration.

    Some controversial ties

    However, Redfield has ties to some policies that are considered controversial, "To Your Health" reports. For instance, Redfield in the early 1980s supported mandatory HIV testing for patients and became closely tied to a congressional effort to pass legislation that would have required HIV testing for health care professionals who perform invasive procedures. Redfield also drew controversy over an experimental vaccine for AIDS created during the early 1990s while he was serving as an AIDS researcher in the Army.  

    According a 2002 report in the Atlanta Journal-Constitution, Redfield also disagreed with AIDS treatment advocates over whether the names of individuals who tested positive for HIV should remain anonymous. Former President George W. Bush was considering Redfield as a candidate to lead CDC at the time.

    Jeffrey Levi, a professor at George Washington University's Milken Institute School of Public Health who served as the deputy director of the Office of National AIDS Policy under former President Bill Clinton's administration, explained that those views were considered controversial because some believed they did "not embrac[e] sound public health approaches to the AIDS epidemic and were stigmatizing of those who were infected." Levi continued, "The context that people have to remember is that during this time, people could be fired for having HIV; they could lose their health insurance for having HIV. That's why there was so much furor."

    Redfield also has long advocated for the use of medication-assisted treatments (MATs) for substance use disorders. MATs involve a drug, such as buprenorphine or methadone, that helps to eliminate an individual's cravings for opioids and withdrawal symptoms without producing the kind of high associated with opioid drugs. Individuals receiving such treatments might have to take the opioid substitute for an extended period of time or for life. FDA has approved three MATs for use in the United States, but some substance use disorder experts have criticized the use of MATs, saying the only effective way to treat a substance use disorder is with complete abstinence.

    According to "To Your Health," Redfield also is considered very religious, which one researcher said "turns off some in the scientific and public health community." However, Redfield is well-respected in his field, "To Your Health" reports.

    Comments

    John Auerbach, president and CEO of Trust for America's Health, expressed concern about whether Redfield has the experience needed to lead CDC. "You want someone leading the organization who has been tested," Auerbach said, adding, "You wouldn't want them to spend a year of their lives learning about the agency they're overseeing. In a crisis, we need someone who can hit the ground running."

    However, Kathleen Kennedy Townsend, a former lieutenant governor of Maryland who served on the board of directors at the Institute of Human Virology, said," I think [Redfield's] a superb candidate, first rate." Kennedy Townsend cited Redfield's experience with addressing infectious diseases and opioid misuse.

    Redfield did not respond to a request for comment on his potential candidacy, And Matt Lloyd, an HHS spokesperson, said HHS did not have a comment on the matter, "To Your Health" reports (Sun, "To Your Health," Washington Post, 3/16; Sanchez, The Hill, 3/17; Diamond/Ehley, Politico, 3/16; Kaplan, New York Times, 3/17).

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