Meet Trump’s New, Homophobic Public Health Quack
The Centers for Disease Control will soon be run by a military doctor with a long history of pushing discriminatory AIDS policies.
The extraordinarily disruptive turnover in the Trump administration’s senior staff has officially reached the Centers for Disease Control and Prevention. The White House, having already cycled through one CDC director, has named its second: Robert Redfield, a retired U.S. Army lieutenant colonel and former University of Maryland opioids and AIDS researcher.
He is exactly the wrong person for the job. Amid an exploding influenza epidemic across the United States, an opioids crisis that has decreased the statistical life expectancy of Americans, and a budget crisis that twice compelled closure of critical laboratory and disease-fighting services, the CDC desperately needs a leader who can promise stability and expertise. Redfield represents the opposite; he is someone whose track record in HIV research and public health policy has been a scientific and moral failure.
The White House, in all likelihood, has carefully scrutinized Redfield’s financial history, especially after it was criticized for failing to adequately vet Trump’s first CDC director, Brenda Fitzgerald, who was forced to resign in January after revelations of multiple conflicts of interest involving stocks and other investments. But Redfield has failed to pass political vetting before — just not for economic reasons. In 2002, President George W. Bush considered but rejected Redfield for the top CDC job because his work on AIDS was deemed excessively controversial. Redfield’s record remains disqualifying today.
Forced testing, forced discharge
From the early 1980s to the early 1990s, when the AIDS epidemic was claiming a staggering death toll, and no treatment for HIV existed, Redfield was a U.S. Army major and vaccine researcher at the Walter Reed Army Institute of Research in Maryland. During President Ronald Reagan’s administration, Redfield guided the military’s public health response to HIV infections within the armed forces and also its pursuit of a vaccine against the virus. In both tasks, Redfield proved extremely controversial.
Among the Defense Department policies that Redfield helped design was mandatory testing of all troops for HIV, without confidentiality, beginning in October 1985. Any soldier, sailor, pilot, or marine who proved to be infected would quickly learn that his entire chain of command was aware of his status, often before he was informed. Recruits were screened, and those whose tests were positive were barred from service.
Active-duty personnel were also tested and if positive would face degrading mistreatment, as I discovered in 1989, when I reported in and around Fort Hood, the Army’s largest training and staging area, located in Texas. Terrified 18- and 19-year-old soldiers found to be infected with HIV would be isolated to a special barracks wing, known on the base as the “HIV hotel” or “the leper colony,” where they were treated like prisoners until they either developed full-blown AIDS or were discharged dishonorably.
The military seemed intent on administratively punishing infected soldiers for their HIV status. Soldiers described being summoned to meet with a chaplain, who would inform them that they had tested positive for HIV, and counsel them while military police rifled through their barracks searching for evidence of homosexuality and the names of possible sex partners. “You go through the Article 15 [disciplinary actions] list and see how many are HIVs,” one discharged soldier told me in 1989. “They are giving out seven or eight Article 15s a day over there. There’s no morale over there.”
About 5 million soldiers and recruits were tested by 1989, with 6,000 of them proving HIV positive. Anecdotally, many of these young men committed suicide, and most were drummed out of the military without medical coverage, dying impoverished from their AIDS disease. If the Defense Department kept score of the tragedy, the eventual, post-discharge outcomes for thousands of HIV-positive military personnel were never publicly documented.
Then-Maj. Redfield defended the Defense Department’s policies, which he largely created. “The reason we have done what we have done,” he told me at the time, “is that we think it’s good medicine — and it’s medicine that might work in the civilian sector, as well.”
Outside of his work with the military, Redfield, a devout Roman Catholic, was associated with Americans for a Sound AIDS/HIV Policy (ASAP), a Christian organization headed by W. Shepherd Smith Jr. ASAP backed the idea of mandatory testing for HIV and isolation or identification of those infected with HIV. Redfield also wrote the introduction to Smith’s 1990 book, Christians in the Age of AIDS. “It is time to reject the temptation of denial of the AIDS/HIV crisis; to reject false prophets who preach the quick-fix strategies of condoms and free needles; to reject those who preach prejudice; and to reject those who try to replace God as judge. The time has come for the Christian community — members and leaders alike — to confront the epidemic,” he wrote. Redfield named the breakdown of family values and increasing number of single-parent households as key factors responsible for the spread of AIDS.
In his book, Smith argued that AIDS was “God’s judgment” against gay people. In 1988, Redfield wrote a 32-page booklet for teenagers, AIDS and Young People, in which he advised delaying sexual activity until marriage to stave off infection.
ASAP and Redfield also backed Kimberly Bergalis, a Florida college student who was infected via a dental visit with David Acer, a dentist who died of AIDS after exposing six of his patients to the virus. Bergalis, who died of AIDS in 1991 at age 23, and her family demanded Congress pass legislation mandating HIV testing of health care workers and removal of licenses to practice for those testing positive. H.R. 2788, sponsored by arch-conservative Rep. William Dannemeyer (R-Calif.), would have revised many aspects of the Public Health Service Act, allowing for testing, loss of licensing, and quarantine of HIV-infected individuals. It ultimately failed to pass but only despite Redfield’s advocacy. “Remember, most Americans don’t feel they have a real risk from AIDS,” he told the New York Times in 1991. “This case worries them, for the only real risk of getting AIDS is from their physician.”
The vaccine hunt that wasn’t
Redfield’s scientific research has been as dubious as his public health work. In the late 1980s and early 1990s, Redfield headed up an AIDS vaccine research effort at Walter Reed that focused on gp160, a protein projection from the type of HIV most commonly found in North America. The military researchers worked together with a Connecticut-based company called MicroGeneSys to develop and test the gp160 vaccine.
The MicroGeneSys product, which the Army dubbed VaxSyn, never proved effective in doing the real job of a vaccine — blocking infection. But Redfield announced at the International AIDS Conference in Amsterdam in 1992 that VaxSyn prevented HIV from destroying key elements of patients’ immune systems, called CD4 cells. It was the first good treatment news a desperate HIV-positive community and their doctors had heard, and it caused an uproar of excitement — I know, because I was there.
But it wasn’t true. Redfield had grossly overstated the Army results, prompting a Defense Department investigation. The department decided Redfield’s “overstatement” of the effectiveness of VaxSyn was an innocent error, but the U.S. Food and Drug Administration was less than impressed with the product and declined to approve continued human testing. Unfazed, MicroGeneSys recruited former Sen. Russell Long to lobby fellow Republicans with the hope of getting Congress to back further testing. In House hearings, Redfield insisted that VaxSyn was within 12 months of being ready for a large-scale human test that would prove the gp160 concoction could stop the disease process. With Smith and ASAP chiming in, Congress was bowled over and approved $20 million for further human experiments. Also in the chorus of VaxSyn backers was then-Secretary of Defense Dick Cheney.
The VaxSyn product never worked, and its elevation to top dog status, despite lack of scientific support, was denounced in the Washington Post as “pork-barrel research.” The “MicroGeneSys soap opera,” as Science reporter Jon Cohen dubbed it, dragged on through investigations and scandal into 1994. Eventually, the Army tried the concoction on more than 600 HIV-positive military personnel, concluding they showed “no clinical improvement.” In his 2001 book, Shots in the Dark, Cohen detailed the Redfield saga and showed that he continued promoting VaxSyn and using it on human volunteers with the financial support of Smith’s ASAP long after the Army had concluded it didn’t work.
Redfield, who had been under consideration for the position of surgeon general, lost his Walter Reed job in June 1994 and was placed on clinical duty in an Army hospital in Washington. Public Citizen cried “whitewash,” insisting Redfield and MicroGeneSys were let off easy. Some of those who were involved in the investigation of Redfield’s activities have started a petition campaign denouncing Trump’s consideration of him for the CDC position.
After the fall
Redfield eventually teamed up with another controversial figure, Robert Gallo, joining his Institute of Human Virology at the University of Maryland in 1996 and has run HIV clinical care programs there ever since. Gallo, who once claimed to have discovered HIV, lost that moniker after years of dispute with French researchers, two of whom were awarded the Nobel Prize. During the Bush administration, which rolled out the enormous President’s Emergency Plan for AIDS Relief (PEPFAR) in 2003, the Gallo group enjoyed strong funding support, and Redfield became a top advocate for the so-called “ABCs of AIDS” in Africa, pressing to prevent HIV infection through abstinence, monogamy, and, if in violation of the first two principles, using condoms.
It’s worth noting here that the entire Institute of Human Virology budget in 2016 was $105 million, a small piece of which was under Redfield’s control. He has never managed anything on the scale of the CDC, with its multibillion-dollar budget and 12,000 employees.
Meanwhile, whoever takes the reins at the CDC will likely oversee massive budget cuts. The White House has called for an overall 10 percent — nearly $1 billion — excision of the agency’s funding. The CDC’s AIDS programs would be reduced along with a range of infectious diseases efforts. Moreover, HIV/AIDS programs such as PEPFAR and programs aimed at tackling malaria, tuberculosis, and epidemic preparedness across the government are slated for major reductions. Global health programs are on the line, as are a variety of women’s health, family planning, gun violence monitoring, and other domestic health efforts.
The CDC will not thrive with Redfield as its leader. He will not serve as a powerful advocate for strong science, expansion of global health and domestic HIV efforts, or separation of religious and empirical perspectives in decision-making. He may not be in possession of hundreds of thousands of dollars’ worth of conflict of interest investments, as was Fitzgerald. But it’s clear that Redfield has plenty of ethical conflicts at the intersection of his religious and scientific views.
Laurie Garrett is a former senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize winning science writer. Twitter: @Laurie_Garrett