Senate Confirms Randall Tobias as Head of Global AIDS Initiative

The Senate by voice vote on Friday confirmed former Eli Lilly CEO Randall Tobias as the head of the new State Department Office of the Global AIDS Coordinator, the AP/San Francisco Chronicle reports (AP/San Francisco Chronicle, 10/3). Tobias was nominated by President Bush on July 2 to head the new office, which was created under the five-year, $15 billion global AIDS initiative. As coordinator, Tobias will work under the secretary of state and will be able to distribute funds directly to nongovernmental organizations and transfer funds between government agencies. The position carries the rank of ambassador. The new office will oversee U.S. international assistance in the fight against HIV/AIDS and coordinate activities of the various agencies and departments that will deliver the aid. Some advocates have raised concerns about Tobias' links to the pharmaceutical industry, saying that he could avoid promoting affordable access to antiretroviral drugs to protect the profits of drug makers. However, during his confirmation hearing on Tuesday, Tobias said he will represent the interests of the United States and employ the most cost-effective methods to help people with HIV/AIDS throughout the world. He also said that he supports Bush's plan to direct most of the funding for global AIDS initiative projects through U.S. programs instead of through the Global Fund to Fight AIDS, Tuberculosis and Malaria. In addition, Tobias said that the primary obstacle to implementing an antiretroviral program in sub-Saharan Africa is a lack of infrastructure, not the lack of available drugs or funds (Kaiser Daily HIV/AIDS Report, 10/3).

Reaction
Global Health Council President and CEO Nils Daulaire said Tobias' nomination "marks a critical juncture in the world's effort to address the global AIDS pandemic. Working together with the AIDS community and those committed to improving health around the world, ... Randall Tobias now holds the key role in achieving the monumental task outlined by President Bush in his State of the Union address." He added, "Only together can we develop and implement effective programs to deliver on the president's promise" (GHC release, 10/3). The AIDS Healthcare Foundation lauded Tobias' Senate confirmation but expressed concern that that "with the clearing of this final hurdle the pressure is squarely on the Bush administration to launch its program with no further delay," according to an AHF release. AHF President Michael Weinstein said, "Congress responded with remarkable speed in authorizing President Bush's global AIDS plan, but success will be measured in lives saved by the next State of the Union, and Tobias must ensure that date arrives with not a token but many thousands in treatment to claim credibility for the U.S. effort" (AHF release, 10/3). Mark Isaac, vice president of the Elizabeth Glaser Pediatric AIDS Foundation, said, "We are elated that the Senate acted to put in place an HIV/AIDS Response Coordinator, and we are confident that Mr. Tobias has the skills and commitment to lead the global battle against AIDS" (EGPAF release, 10/3). Isaac added, "The next crucial step is for Mr. Tobias to quickly move the necessary resources into the field to help the millions of children and families suffering from HIV/AIDS" (Groppe, Indianapolis Star, 10/4).