Dybul Out: Thank you, Hillary!!!


Sworn in as Secretary of State just yesterday, Hillary Clinton wasted no time cleaning house at the vast department she runs. Today, we have heard, Mark Dybul was asked to submit his resignation as US Global AIDS Coordinator, head of the office in charge of the President’s Emergency Plan for AIDS Relief.

This is a huge first step to ensuring the health and rights of all people at risk of HIV and AIDS: Dybul oversaw the last several years of abstinence-only programs funded by PEPFAR, hob-knobbed a bit too closely with the far right, and never saw a law or policy restriction he could not make even more restrictive. Curious for a self-identified Democrat? Not so curious, I guess, if your career is dependent on pleasing the far right, and if your desire to be Global AIDS Coordinator outweighs your desire to stand up for what is right. Under the Bush Administration, brave professionals such as Susan Wood, then-Assistant FDA Commissioner and Director of the Office of Women’s Health, resigned rather than carry out policies that compromised science, evidence, ethics and human lives. Dybul instead did everything he could to work with the far right to tighten policies, deny women access to reproductive and sexual health care, and put in place guidance that further restricted women’s choices. I have no doubt that as a result people in countries like Uganda were needlessly infected with HIV under his regime and because of the policies he supported through his unwillingness to stand up and speak out.

But we no longer have to abide such policies. Hillary Clinton has taken swift action to show she will stand up for the health and rights of people everywhere, for evidence-based policies to promote women’s health. She and our new President deserve our deep appreciation.

Thank you, Hillary!

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  • invalid-0

    great news indeed! So is this what comptrtent government feels like? It’s been so long it may take time to adjust.

  • invalid-0

    AHHHHHHHHHHHHHMENNNNNNNNNNNN! or whatever outcry you prefer to express deep appreciation and agreement with a given statement or sentiment! I think that given the ludicrous levels of incompetence and malfeasance we’ve semi-tolerated for the past 8 years, it may ‘take some getting used to’ but I am certainly happy to put some energy to adjusting!

  • invalid-0

    It is a great thing to have a leader who understands – who really “gets” – that our issues must be front and center, not an add-on that you deal with when you finally get around to it, or a bone you throw to a ‘special interest’ constituency. I can’t wait to see what Hillary changes next. At long last….

    And thank you Jodi for your activism… talk about getting results!

  • invalid-0

    Wow, it’s so surprising that a liberal democrat is cleaning house in a department that has been run by a republican for 8 years.

    Hellary’s a real trailblazer! This is a first! Let’s thank her for doing something every politician assuming a new office does! Yippee!

  • invalid-0

    Great Start and great news!! Sure wish we could sned her a Thank you to her wesite from RH…..
    The old administration knew Abstenince Only never worked BUT they were too dam stuborn and stupid to stop it!
    This “CHANGE” must continue and I’m confident it will with our new leadership in office now!

  • alexm

    I’m jealous.  We need Hillary to do some cleaning of our Parliamentary House. 

    The personal is political.

  • anngarrison

    I can’t tell you how glad I am to see Mark Dybul out.  I wrote my own blog post about this, after speaking on two Pacifica Radio stations, and one Native American BlogTalk show about Obama, Dybul, Rick Warren, and PEPFAR; I had noted that there was a special allocation for PEPFAR in Native America when the bill was refunded last July, for more than twice the billions it received before, but haven’t yet been able to find any news of PEPFAR’s consequence, in Native America thus far.  The background of my own interest in all this is the Congo War, and I’ve learned much of what I understand about PEPFAR from RHRealityCheck.org .   

    .http://digg.com/world_news/Victory_for_Africa_Obama_Dumps_U_S_AIDS_Czar_Mark_Dybul

     

    There, I wrote: The problem with PEPFAR, the President’s Emergency Plan for AIDS Relief, has been not only that its so-called HIV prevention efforts actually cause HIV infection rates to rise, because so much funding for prevention is restricted to faith-based "abstinence only" efforts, but also that PEPFAR is used, in a number of ways, to advance U.S. imperial interests, military, military industrial, and corporate.  

     

    Though we can thank Hillary for dismissing Dybul, her stance, and her husband’s, in Rwanda, Congo, and Central Africa, and the Rwandan Army’s entry into Congo on Inauguration Day, are not promising and shouuld be question as a new PEPFAR emerges. 

     

    -Ann Garrison, San Francisco, CA

  • invalid-0

    As a former PEPFAR employee who worked both in Washington and Tanzania I can wholeheartedly say that PEPFAR did a world of good,;especially under the leadership of Dybul. There were indeed political ideologies to be satisfied – at least on paper – but in the field we found ways to keep the funding going but still implement what would work on the ground. It is not by accident that PEPFAR receives bipartisan support – all the earmarks are necessary to keep both sides happy and consequently keep the funding flowing! That is the reality.

  • invalid-0

    I think most people who actually worked with Dybul would agree that were it not for him, PEPFAR would not have been the success that it has been. Perhaps there is need now or eventually for new leadership for the next phase, but that is a totally separate issue from whether Dybul was what was needed to get PEPFAR going and to be even in a position to begin to address what were impossible issues during the prior administration.

  • jodi-jacobson

    For your comment.

    However, I could not disagree more with your statement that:

     

    There were indeed political ideologies to be satisfied – at least on
    paper – but in the field we found ways to keep the funding going but
    still implement what would work on the ground. It is not by accident
    that PEPFAR receives bipartisan support – all the earmarks are
    necessary to keep both sides happy and consequently keep the funding
    flowing! That is the reality.

    First, having spent a good deal of time on the ground myself and having sent staff out to the ground, having worked on this legislation for over 6 years, even before PEPFAR was PEPFAR, and also having read thoroughly many times the GAO and IOM reports on this issue (as well as many other reports), it is clear that prevention programs were not working.  They were not finding adequate ways to "still implement what would work on the ground."  While there were instances of projects that did manage work arounds, these were the exception.  In a public health crisis and with billions of dollars at stake, funding programs as a rule that do not work is not acceptable no matter how many exceptions you can find.

    On the bipartisan piece, this is/was a line that was created–and unfortunately bought by too many–by those whose major aim was to keep the money flowing, not to make sure we were spending the money the right way.  The first PEPFAR bill was passed after Senator Frist threw out his own, much better bill, when the Republicans took over both houses and the evangelical right went to the White House with specific demands for prevention policy that went against all public health priorities.  Senator Frist could at that time fought for what was right; President Bush could have.  Many could have, none did.  Democrats were complicit in this, no question, but they did not have the power to change it at that moment.

    In PEPFAR reauthorization, we had a great draft bill for which we had more than sufficient votes.  It was changed in the 11th hour to accommodate the US Conference of Catholic Bishops and the evangelical right, as well as a small minority of legislators.  This is unacceptable.

    This was capitulation, not compromise.

    That we had to do this for the sake of bi-partisanship and to keep the money flowing is belied by the fact that now, even having gotten "their way" the Republicans are threatening not to fund this and other programs as a way to undermine Obama.

    For my part, I’ll skip the "bipartisan" efforts to put into place bad policies and then make the US taxpayers foot the bill.

    Thanks much for writing and I encourage you to write again.

  • jodi-jacobson

    Can you define success here?

    Unquestionably we have put people on treatment.  However in an epidemic with estimates ranging from 3 to 6 new infections for every person put on treatment, I hardly think it is a success to spend billions treating people when your prevention policies are based on ideology and leave huge numbers of people at risk.  There have been medical and treatment access successes; these are unsustainable over the long run as many of us have said for a long time, unless we have in place an effective evidence- and rights-based strategy to end the spread of HIV.  We did not, and still do not.

    Mark Dybul, as head of this program and as the one who time after time defended it in hearing after hearing, who could not even admit that there were problems with prevention programs after the GAO and IOM reports came out and who spent a great deal of time coddling far right groups whose main interest was in getting money to proselytize shares the blame in this.

    There is a tradition in this country of speaking truth to power.  Mark had power and never spoke the truth about the problems with prevention policies.  He chose, after PEPFAR was reauthorized, to write guidance forbidding funds for purchases of contraception for HIV positive women seeking to avoid getting pregnant.  

    I don’t doubt there were good things Mark did.  On the whole, he provided no leadership, vision or pushback on this policy that could have made it different.  He could have used his power to change the discourse.  Groups that have considerable power in this debate supporting him and promoting reauthorization of PEPFAR did not push for change.

    As far as I am concerned, public officials have to be held accountable for the policies they support.  Dybul did not take the steps that should have been taken.  He needs to be accountable for that.

    Best wishes, Jodi

  • invalid-0

    http://www.washingtonpost.com/wp-dyn/content/article/2009/01/27/AR2009012702673.html

    Your comments have been extremely helpful in understanding the drivel this man has spewed today.

    Thanks

  • invalid-0

    Hard to see how the sudden sacking of the leader of an organization improves its effectiveness. It seems to me that an effective boss, such as Hillary Clinton, can change a few policies at PEPFAR without creating a leadership vacuum. Were PEPFAR’s activiteis *SO* damaging that it was better fire Dybul than to have some sort of organized transition? To me this smells of petty, & misguided vengance, not calm and rational leadership. If PEPFAR is so screwed-up, then it is better to shut it down and create something new; if it is working reasonably well, but needs some new rules &/or leaders, then spell out the new rules and make some smart tranitions w/ key personnel. Which was it people? I honestly don’t know.

    I want to believe in the change that Obama promised to bring to Washington, but news like this makes it difficult. Someone please do a better job of explaing why Dybul’s firing was so important that it had to be done “on day one”.

  • invalid-0

    This sounds a lot like the White House travel office screw-up repeated.

  • invalid-0

    During 8 years in which gays, RH advocates and progressives were excluded from the political process with near totality, some chose to improve outcomes by working within the system. This group is often chastised from within and without.

    Cheers to Mr. Dybul.

  • http://bour3 invalid-0

    Dybul out: Thank you Hillary

    Partisan haters are idiots. In this case, exceedingly harmful idiots. Take a bow, you just killed hundreds of people. But that’s OK, anything to satisfy your own partisanship, so ingrained you’ll distort any truth to make things fit. Let’s do each other a favor and keep our distances.

  • invalid-0

    you disgust me with this. President Obama has stressed a bipartisan end to the last 8 years but you take delight in the firing of a man who saved countless lives in the intolerable circumstances of Bush. You need to be purged also.

  • invalid-0

    By all accounts (except people whose eyes are glued shut) Dybul helped save 2 million lives. Now, because he dared recommend a comprehensive approach that included (gasp) abstinence, he’s O-U-T with no replacement ready to step into a critical job. Nice planning, Team Obama. Can’t wait to see what the rest of your, um, four-year tenure holds.

  • invalid-0

    Mindless celebration of the dismissal of a very good man. With no replacement in sight, there are sure to be lives shortened by this dispicable action. And yet you celebrate the move?

  • invalid-0

    See, he helped save lives and slow the spread of AIDS–but he did it in a way that we don’t like. He dared suggest that abstinence could prevent the spread of a sexually-transmitted disease! And we all know that’s just crazy talk.

  • invalid-0

    Mr. Dybul should have known better than to suggest that people might be able to control their behavior. Governments are supposed to clean up behind their citizens. How dare he expect responsible behavior from adults.

  • invalid-0

    All of you who are dancing in the aisles…go to the worst place in the world and save a COUPLE MILLION lives with expensive drugs requiring detailed dosage compliance by people who are about 50% illiterate in an environment without effective roads, and then hold forth on how we can all be happy this “horrible person” is gone.

    This is serious. Real actual human beings are going to die who didn’t have to if this transition were handled in an organized and sensible manner. Sure he had to go. Of course he had to go. We all know that the left must punish heresy and that, regardless of the fact that this guy saved more people than Pol Pot killed he must be shat upon and made to suffer for not hating George W. Bush so violently and publicly he could not have held his position and done the good he did. He’s a heretic and a “bad” gay, and he needs to be subjected to a FBI investigation, and an IRS probe, and reviled and others need to be found to take credit for his work…but for godsake can we have a little mercy on children who are going to lose their parents, the mothers who are going to lose their babies, and the other sufferers who are going to pay with their lives if we screw this up? How many lives is your momentary joy worth?

    PS: As an atheist, I wholeheartedly reject every aspect of the Bush evangelical agenda, and I think calling abstinence a form of birth control is an abuse of the English language. Abstinence is not birth control, it is everything you do when you are not having sex. There are a lot of us who would be with you all more if you cared less about your own feelings and more about the people you are supposedly concerned about.

  • jodi-jacobson

    Mark Administered a program.

    The treatment access goals were written into the law.  He did not have to do much to achieve them but get the funding out to the people who needed to do the work, and oversee the program effectively.  There are any number of people imminently qualified to do this, without playing the ideological game Dybul constantly played.  Moreover, it simply is not true and represents a misunderstanding of the ways in which funding is disbursed to assume that any funding or programs will either slow or stop while his successor is found.  That is controlled by Congress, the funding already is in the field for this year, and this comment could not be further off the mark nor more based in fear-mongering.

    Sorry.

     

    Jodi Jacobson

  • jodi-jacobson

    Were PEPFAR’s activiteis *SO* damaging that it was better fire Dybul than to have some sort of organized transition?

     Yes, they were so damaging and unfortunately still *are* so damaging.  Public relations strategies are a powerful thing.  Understanding what is below the PR is important.  PEPFAR had a huge PR function for itself and for Bush, who used it, in my opinion, as a way of a) deflecting the horrors of the Iraq war; b) to fund evangelical and other faith-based groups; and c) to provide treatment.  The last is a good thing.  The prevention policies are a disaster. See comments above; see analyses of this issue extensively on this site.

    Dybul, as leader of the program, did not run the day to day, so that work goes on….does any corporation cease to exist if its leader is fired?  Should no one be held accountable? Do you assume that one person is running a program of many billions of dollars? No.

    What Dybul was responsible for, however, was vision, politics, evidence, and leadership.  He had the wrong politics, put his job before the evidence, and providing no leadership where it was most needed.

    Dybul ignored the findings of major independent institutions that sought to increase accountability of PEPFAR.  He promoted policies that left people at risk to placate powerful constituencies.  This was not ok, and frankly it was not only politically as important to get rid of him as it was to get rid of other people in the Bush Administration–we did have an election you know–but he continued to do damage.

    See today’s post for more evidence of this.

    Best wishes, Jodi

  • invalid-0

    Matt Barber, director of cultural affairs at Liberty Counsel and Liberty Alliance Action:

    “Here we have a man who is engaged in the lifestyle that is almost single-handedly responsible for the spread of AIDS in the United States of America, and he’s an open homosexual. And the CDC [Centers for Disease Control] statistics show that still, overwhelmingly here in the U.S., men who have sex with men are highly susceptible to HIV/AIDS,” he points out. “And here’s this man unapologetically engaging in the behaviors that cause AIDS, as the AIDS czar. It just really turns logic and reason on its head.”

  • jodi-jacobson

    I am not clear as to the point of your post, but Mr. Dybul’s sexual identity has nothing to do with his job one way or the other.

     

    Jodi Jacobson

  • invalid-0

    ” …several years of abstinence-only programs… “#

    Ah, the loony left (as they are known here in Britain) and lies. Go together like, well, peanut butter and jelly. I think they’re disgusting but a bizarre number of Americans seem to like them.

    There was never any “abstinance-only” programme. That was made up by the left who could not accept that Bush was doing the right thing (it’s known as Bush Derangement Syndrome, and is really weird and truly scary). They therefore could not accept that a gay Democrat could work with Bush, even though he helped maybe 2 million people by doing so. Far worse to work with Bush than condemn 2 million people.

    So thus was born the myth of the “abstinance-only” programme. Thus people like Jodi Jacobson would rather people die than someone who helped Bush in his most philanthropic programme kept his job for a few months.

    Jodi, you disgust me. You are a revolting person. I am glad I am 4000 miles away from you.

  • invalid-0

    Sorry to come back so soon, but I have just read a transcript of an interview with Dybul, so have a little more to say.

    I am truly, utterly disgusted with you Jodi Jacobson.

    You have told an unashamed, deliberate, stupid lie. You have supported someone who has used that lie to kill thousands, all for trivial, petty political gain. Abstinance only ever took one third of the budget, and you must have known this.

    That is the sort of nasty, tribal, self-righteous and self-centred politics that the left is so good at. Politics and image is far more important than actually helping people. It revolts me, and this is why I am right wing, because I would rather help people than pretend to help people.

    You really do make me sick.

  • jodi-jacobson

    health insurance policy.

     

    best wishes!

     

    Jodi

  • invalid-0

    Ms Jacobson, you did not respond to the charge in the previous email. Richard says “abstinence education” only took 1/3 of the budget. Gerson says Dybul used an eclectic approach combining contraceptives and encouraging abstinence.

    Are you misstating the case, or not? If you are, will you correct your post?

    You say you “have no doubt” that rates of HIV increased. Do you KNOW that? If you are going to refute the general consensus that Dybul’s program saved lives, can we have some stats to support your assertion?

    Frankly, if what the guy did was effective, who cares if he “hobnobbed with the far right”? People like you just can’t stand the idea that anybody but liberals care about helping people. If you can’t make a case for your claims, you are just being a demogogue.

  • jodi-jacobson

    The IOM Report, and OGAC’s own data.

    In FY 2004 through 2007, nearly 60 percent of funding for prevention of sexual transmission went to abstinence only programs.  Read the evidence.  It is well-documented.  Gerson ignores it.  I don’t care to engage him.

    In Nigeria, 70 percent of all funding for prevention of sexual transmission went to abstinence programs, in Uganda 56 percent and so on.

    Just because you put flour, sugar, salt, and baking powder on the same counter, you do not have a cake.  If you fund abstinence only programs reaching individuals with only abstinence information, and you send condoms to sex workers in the same country, you do not have a comprehensive program.

    And see recent data on Uganda.

    I have visited these countries, these programs, the public health practitioners the program managers, the government officials…everyone who wants to have an honest conversation with these people gets the truth about these programs.

    Sorry….I am no longer interested in fighting this battle with people who refuse to read the evidence produced by their own government agencies.

    Dybul is gone and the program will change.

    Many of us are quite happy.

    Jodi

  • invalid-0

    I agree with your comment, Doug. I’m a fairly high ranking government employee – high enough to see the sausage being made now & then, anyway. I can practically guarantee you that the abrupt dismissal of the head of agency will be disruptive & possibly demoralizing. What should have been done is for a politically compliant deputy to have been put in place for a few months, and then the head of agency asked to resign & one of the deputies taking over as acting head of agency while the new head of agency is selected & confirmed, if necessary. This means that the acting head of agency would a chance to get a grip on whatever staffing & budget issues are most pressing, and to figure out how to shift direction, if that is what is needed. When the new head comes on board, it will be to a situation in which the conditions for the new direction to be successful will have been established, without the agency ball being dropped along the way.

    Clinton doesn’t seem to have learned anything in the Senate.