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Robert Redfield INSTITUTE OF HUMAN VIROLOGY AT THE UNIVERSITY OF MARYLAND SCHOOL OF MEDICINE

Trump’s pick to lead CDC both celebrated and censured

Robert Redfield, an HIV/AIDS researcher and clinician who has weathered his share of controversies over a long career, will soon become the next director of the U.S. Centers for Disease Control and Prevention (CDC) in Atlanta.

“Dr. Redfield’s scientific and clinical background is peerless,” Alex Azar, secretary of the Department of Health and Human Services (HHS) in Washington, D.C., CDC’s parent agency, said in a press release issued today announcing the appointment.

Redfield co-founded the University of Maryland’s Institute of Human Virology (IHV) in Baltimore, Maryland, which opened its doors in 1996. His most recent work has focused on helping improve HIV/AIDS prevention and treatment efforts in both Baltimore and several sub-Saharan African countries (through funding from the President’s Emergency Plan for AIDS Relief). He previously spent 20 years in the U.S. Army’s Medical Corps, heading its department of retroviral research.

Although Redfield is a respected researcher, he has drawn criticism for his support decades ago for mandatory HIV testing of military recruits (and a plan to bar anyone who tested positive), as well as his role in a controversial clinical trial of an AIDS treatment that took place in the 1990s. Earlier this week, Senator Patty Murray (WA), the top Democrat on the Senate health committee, wrote to President Donald Trump to express her “concern” about Redfield, “given his lack of public health credentials and history of controversial positions regarding the prevention and treatment of HIV/AIDS.”

Reaction to the pick has been mixed.

Redfield is an “outstanding choice” to head CDC, says James Curran, who headed CDC’s HIV/AIDS program in the early years of the epidemic and now is dean of the Rollins School of Public Health at Emory University in Atlanta. “It’s nice to have someone competent and committed to HIV/AIDS,” says Curran, who stresses that a prime requirement for the CDC job is to respond to infectious diseases. “Most of the bad things he was associated with were quite a while ago and, unlike some of the people involved with AIDS in the beginning, he’s been really, really committed for a long period of time.”

He has a controversial past, but whether that means he has a controversial future at CDC is hard to tell.

Gregg Gonsalves, Yale Law School

Robert Gallo, another co-founder of IHV and the co-discoverer of HIV, described Redfield as the “ideal candidate,” noting that he’s “a dedicated and compassionate physician who truly cares about his patients” and “consistently demonstrates strong public health instincts that are grounded in science and clinical medicine.”

But many people in the public health community and within CDC had hoped that the job would go to Anne Schuchat, a career CDC employee who has been serving as the acting director since Brenda Fitzgerald resigned in January after reports that she invested in tobacco companies. Curran notes that, with few exceptions, the director has always come from the outside. “It’s very important that the administration and [HHS] have its own person,” Curran says.

Sharp criticisms of Redfield have been circulating ever since Politico first reported on 16 March that the Trump administration would likely tap the researcher for the job. In her 19 March letter to Trump, Murray recounted how Redfield was investigated in 1993 by the Army for allegedly misrepresenting data from a trial of an experimental AIDS vaccine meant to treat infected people. Redfield had claimed supposedly promising results from a small clinical trial of the vaccine, which at the time was at the center of a high-powered congressional lobbying campaign, first revealed by Science, that attempted to side-step peer review and fund its expanded testing. The investigation cleared Redfield of scientific misconduct, though it did criticize him for his “close relationship” with a group called Americans for a Sound AIDS/HIV Policy (ASAP) that was founded by evangelical Christians.

Sean Strub, founder of POZ magazine (written for HIV-positive people), recently lambasted the idea of Redfield heading CDC in a blog post, referring to ASAP’s leaders as “ultra-right conservative anti-gay activists.” Peter Lurie, who heads the Washington, D.C.–based Center for Science in the Public Interest, said the appointment would be “disastrous,” asserting that Redfield was “a sloppy scientist” and had “supported a variety of policies related to HIV/AIDS that are anathema to the great majority of public health professionals,” including quarantining HIV-positive individuals in the military.

Epidemiologist Gregg Gonsalves of Yale Law School, who was a leading AIDS activist in the early 1990s, remains concerned that Redfield is on the board of an organization that grew out of ASAP, the Children’s AIDS Fund International. “He needs to clarify where he stands with regard to their thinking,” Gonsalves says. But he’s open to the idea that Redfield’s views have changed and is glad to see someone leading CDC who understands “the fault lines and politics” of infectious disease outbreaks and epidemics.

“I’m willing to give him the benefit of the doubt,” Gonsalves says. “He has a controversial past, but whether that means he has a controversial future at CDC is hard to tell.”

Redfield did not respond to a request for comment.

His appointment does not require Senate confirmation, and he could quickly be sworn in for the job.