The Trump administration has named virologist Robert Redfield to run the Centers for Disease Control and Prevention (CDC)—yet another in a long line of inexperienced, dangerous picks. And, worse still, the position doesn’t require confirmation by the U.S. Senate, so there’s no opportunity for a public discussion.
The previous head of the CDC, Brenda Fitzgerald, was found to have invested in tobacco stocks, an odd choice for someone who is supposed to be dedicated to anti-smoking efforts. And at first glance, Redfield doesn’t seem so bad. He’s a virologist and a professor at the University of Maryland School of Medicine. He’s done AIDS research for several decades now and heads up programs providing HIV care. But dig a little deeper into his past, and things get very bad, very fast.
Though he has very minimal experience in the administration of public health policy, this isn’t the first time Redfield has helped shape the government’s stance on HIV and AIDS. Under George W. Bush, Redfield was named to the Presidential Advisory Council on HIV/AIDS (PACHA). Back then, he was promoting a long-discredited theory that abstinence-only education was the best way to combat the spread of the disease.
In 1996, an abstinence-only advocate testifying before a congressional subcommittee discussing abstinence-only sex education referred to Redfield as a proponent of the view that the breakdown in the American family—that tired conservative shibboleth—was the root cause of increased HIV infections. Why? Because in 1988 he thought—and, for all we know, still thinks—that single-parent households lead to more opportunities for multiple sexual partners. He was also connected to a group called Americans for Sound AIDS/HIV Policy (now the Children’s’ AIDS Fund), which was founded by evangelical Christians. Indeed, his relationship with them was so cozy that the Army found he had inappropriately shared with the group scientific data that he obtained while working at the Walter Reed Army Institute of Research.
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His research career is checkered as well. During the early 1990s, Redfield worked as the principal investigator for an HIV vaccine clinical trial at Walter Reed. Redfield’s results weren’t replicable, and there were allegations that he engaged in data manipulation and misleading presentation of data. The current head of clinical pharmacology at Johns Hopkins University School of Medicine, former Air Force Lt. Col Craig Hendrix, raised concerns about Redfield’s research at the time and described Redfield’s data as either “egregiously sloppy” or fabricated outright. His results were described as exaggerating the benefits of an AIDS vaccine in development. Even though the vaccine was a bust, Redfield continued to administer it to non-Army HIV-positive people even after the Army had shown the vaccine didn’t work. Redfield claimed that individuals who received the vaccine showed stable CD4 cell counts (a measurement of immune system damage in HIV-positive individuals) while the CD4 count in a control group declined. Re-analysis of Redfield’s data showed that was not the case.
For someone who has dedicated his professional career to research on HIV and AIDS, Redfield has also been startlingly homophobic. He was the architect of the 1980s rule that all troops be tested for HIV. If they tested positive, their entire chain of command was informed, sometimes even before the servicemember was told. They were then housed in a separate barracks and treated like prisoners. Their living quarters were searched to see if there was any evidence they had sex with other men—because of course at this time AIDS was almost exclusively associated, in the public mind, with being gay. Ultimately, those soldiers were often dishonorably discharged.
Recruits were tested too, and if they tested positive, they weren’t allowed to serve.
Redfield’s desire to implement forced testing wasn’t limited to the military. In the 1980s, he believed that if you went to the doctor for a routine physical or wanted to get a marriage license, you should have to undergo HIV testing. He backed a 1991 congressional effort to mandate HIV testing of all health-care professionals who did any sort of invasive procedures. He fed AIDS hysteria by saying that for most Americans, they feel the “only real risk of getting AIDS is from their physician.” That statement neatly encapsulates what appears to be Redfield’s worldview about HIV and AIDS at the time: “Most Americans” won’t get the disease because they’re good people, not men who have sex with men, but those good Americans should also live in fear of their doctor having AIDS. This hysteria was driven by the fact that one HIV-positive health-care provider—David Acer, a dentist—did infect six patients in the late 1980s. However, a review of 57 other HIV-positive health-care professionals working at the same time showed no infections across 19,000 patients. It remains the only case of clinician-to-patient transmission.
Besides the fact that the CDC should be helmed by someone clear-eyed about major issues instead of an ideologue—especially considering the continued problems with HIV and AIDS in the United States—there’s no indication that Redfield is prepared to lead an agency with 12,000 employees and a $7 billion budget. Redfield is associate director of the Institute of Human Virology at the University of Maryland, and organization that has 300 employees and a budget of $105 million.
There’s an outside chance, of course, that Redfield’s social views on HIV and AIDS have significantly evolved since then. And indeed, his continued work with HIV-positive people in the Baltimore area is laudable. There’s even a chance chance that he’ll flourish at running an incredibly large and complex agency even though he has no background running anything of the sort.
However, it’s distressing that his past beliefs, combined with his very thin public health experience, wouldn’t disqualify him from heading the CDC. Sadly, it’s likely that the Trump administration views all of those qualities as features, not disqualifying factors. He’ll fit right in.