“Before there was PEPFAR or the Global Fund, Dr. Birx was leading the charge in changing this disease,” Sen. Ben Cardin (D-MD) said Thursday, as he introduced his constituent, and President Obama’s nominee to be the next United States global AIDS coordinator to the Senate Foreign Relations Committee. “I don’t think I’ve ever introduced a person so qualified for a post.” Birx answered questions from the committee in the hearing that followed. A Senate vote on her nomination will follow, but has yet to be scheduled.
“Congress should hold me responsible to the roadmap,” she said, referencing the PEPFAR Blueprint: Creating an AIDS-free Generation released in 2012, when Sen. Ed Markey (D-Mass) asked her to state her goals for the position. Birx also said she’ll bring her focus to measuring impact at the CDC to PEPFAR, measuring the impact of interventions including treatment, prevention of mother-to-child-transmission, and male circumcision.
Birx laid out four key areas she’ll focus on as the new global AIDS coordinator:
- Scaling of effective interventions, including treatment, prevention of mother-to-child-transmission, male circumcision, and other evidence-based interventions
- 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
- Sharing responsibility for the epidemic with countries, and collaborating with civil society and multilateral partners like the Global Fund, UNAIDS, and the WHO
- Ensuring enhanced transparency, accountability, and oversight of PEPFAR
“Our challenge is to maintain our focus,” she said. “If we begin to drift, to lessen our aspirations, or to stray from the scientific method, we will have squandered our accumulated assets and allowed the accomplishments of the last decade to unravel, with enormous negative consequences to a great many young lives.”
Since the beginning of PEPFAR, Senator Bob Corker (R-TN) noted, 50 percent of funds must go toward treatment, and, he added, the PEPFAR Stewardship and Oversight Act that renewed authorization for the program in 2013, emphasizes this. Birx, asked if she will make sure that PEPFAR is compliant with the law, responded with one word: “Yes.”
Senators Markey and Tim Kaine (D – VA) said they were concerned with recent anti-homosexuality legislation enacted in Nigeria and Uganda, with Sen.Markey saying that such laws compromise PEPFAR’s work. Birx said she is deeply disheartened with the laws, which “represent a step backward to a time 35 years ago when we should be moving forward.”
“This is an incredible setback for people to receive services,” she said, noting that communities can’t lower viral load if all people don’t have access to services. “It’s in all countries’ interests to encourage access to services.”