Lancet Examines Global Health Advocates’ Concerns Over Tobias’ Confirmation As Foreign Aid Coordinator, USAID Head
The April 8 issue of the Lancet examined some global health advocates' concerns that the confirmation last week of Randall Tobias as the new administrator of USAID and the first director of foreign assistance at the State Department "could result in diversion of funds from economic and social development to more immediate political issues" (Bristol, Lancet, 4/8). Secretary of State Condoleezza Rice in January nominated Tobias -- who is head of the State Department's Office of the U.S. Global AIDS Coordinator and former CEO of Eli Lilly -- for the post, which gives him a rank equal to that of deputy secretary of state and allows him a planning staff at the State Department. Tobias as the new director of foreign assistance will oversee all U.S. foreign aid programs, and, although the restructuring does not merge USAID and other State Department programs, the move is meant to bring USAID closer to the department, officials have said. Some HIV/AIDS advocates have criticized Tobias' nomination, saying he has favored abstinence-only HIV prevention programs and has not supported inclusion of generic drugs for HIV/AIDS treatment in developing countries (Kaiser Daily HIV/AIDS Report, 1/20). "Tobias has been all too willing to accede to the demands of the extreme right in developing policies and programs based on ideology rather than evidence," Jodi Jacobson, executive director of the Center for Health and Gender Equity, said. Tobias has said he supports the use of generic drugs if they are proven safe and effective, and President's Emergency Plan for AIDS Relief officials have said that providing more funding to abstinence-based programs was mandated by Congress (Lancet, 4/8).
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