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New AIDS czar a good fit

Amid the furor over swine flu, a very important bit of health policy news seems to have been buried. President Obama just appointed a new AIDS czar, who will have as much $48 billion at his disposal. Eric Goosby, MD, medical director at the Pangaea Global AIDS Foundation in San Francisco, will take over the job, an appointment that was widely expected and welcomed in the AIDS community. He will be in charge of the President's Emergency Plan for AIDS Relief, or PEPFAR.

About Goosby
"I think he is superbly positioned for the job," said Eran Bendavid, MD, a fellow in infectious disease and health policy at Stanford. "He has a very strong background in global health, policy, and HIV. He is a charming and charismatic character, and will be a very strong ambassador for the U.S."

Goosby has been in the trenches; he treated HIV/AIDS patients in the early days of the epidemic at San Francisco General Hospital (I was a staff writer there at the time and remember him working in Ward 86, the country's first AIDS clinic). He later became director of the Office of HIV/AIDS Policy in the Department of Health and Human Services and was an advisor to the president on HIV/AIDS issues. He has helped shape widely used treatment and prevention guidelines in this country and is well-respected by his peers.

PEPFAR Explained
The program he'll direct was one of few initiatives under the Bush administration that's been widely praised. The program was initially authorized in 2003 at $15 billion over five years; last year, Congress pledged to increase it to $48 million, with the spending devoted to a three-pronged attack on AIDS, tuberculosis and malaria.

I saw the benefits of the program first hand while in Africa. Many of the HIV-positive patients I met had been able to get antiretroviral therapy courtesy of PEPFAR. Some 2 million people, most of them in Africa, are on life-saving drugs that are paid for by the program. "PEPFAR funding has had a really significant impact," Ruth Nduati, MD, a renowned specialist in pediatric AIDS and professor at the University of Nairobi, told me during a visit to Kenya during the early days of the program. "Those resources have enabled us to begin to implement health services that will make a difference for women and children in this country."

Until recently, the person in charge of PEPFAR was Mark Dybul, MD, a gay physician who once practiced in San Francisco. According to news reports, he was asked to stay on by the Obama transition team, but once Hilary Clinton was installed as Secretary of State, he was unceremoniously dumped. Since then, Goosby's name had been widely circulated as the likely pick for the job.

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