Why Dybul Was Sacked: New Details Emerge

A furor has arisen among some right-wing conservatives and some AIDS treatment advocates regarding the departure of Mark Dybul as the US Global AIDS Coordinator.  And because the right-wing sees two basic causal factors in every problem (taxes and sex), it has now become the cause celebre to fault reproductive health and prevention advocates for causing Dybul’s dismissal.

Dybul not only did not advance, he set back efforts to prevent HIV infection, especially among women and youth—the groups most at risk in the AIDS epidemic—so it would be hard to say we’re sad to see him go.

But for those still mourning Mark’s empty chair, consider this:

Last week–after the new Administration had made plain that it was putting a halt to development of new regulations and new guidance until it could review both law and policy–Dybul was found on the Hill lobbying for a more restrictive interpretation of the PEPFAR conscience clause than currently exists, with the intention of placating the Catholic Church.

In the first phase of PEPFAR, a conscience clause existed that was in itself onerous enough.  This first clause was written by conservatives to allow groups receiving PEPFAR funds to refuse to provide certain kinds of services.  So, for example, Catholic Relief Services (CRS) or the United States Conference of Catholic Bishops (USCCB)–which rejects family planning, condoms for HIV prevention, GLBT people and….well many other things in the real world–could receive PEPFAR funding for prevention of sexual transmission but refuse to provide condoms.

The clause was, however, interpreted by saner heads still remaining somewhere in the Bush Administration apparatus to require some sort of referral on the part of these groups. 

An example: Let’s say that CRS or the Bishops were trying to prevent new infections within HIV-discordant couples (one spouse is positive, the other is not…they are married…we are not even talkin’ unmarried people) under the original conscience clause.

Their answer would be: don’t have sex.  (Seriously…I was at a conference in Abuja, Nigeria where it was suggeted by PEPFAR-funded faith based groups that these couples, rather than using condoms, simply "find other means of expressing marital love than through physical affection….for the rest of their lives.")

Public health professionals within USAID recognized that increasingly it is women whose husbands are not down with this no-sex strategy who are getting infected all across Africa.  So guidance was written to require groups "protected" by the conscience clause to offer referrals if they could not provide services.  Under this interpretation, a group such as CRS would have to ensure that they were partnered with, or linked to, or could refer to an organization or program that would in fact counsel those discordant couples who desired to actually have sex on how to use condoms correctly and consistently, and actually provide condoms to them.

This "liberal interpretation" of the use of your taxpayer dollars irked the Catholic Church and many like-minded evangelical groups.  So they fought for–and with Mark Dybul’s help won–an even more restrictive policy in the PEPFAR reauthorization last year, guaranteeing for example that they need not even provide care to those people they did not like.

Now it appears that the groups in question, concerned that the Obama Administration and the Democratic Congress would more flexibly interpret the new and more restrictive conscience clause, went into action, again with Dybul as their personal savior (speaking rhetorically).

Several legislators knowledgable about the clause and its adverse
impacts had indicated their willingness to soften it in forthcoming
legislative action, with the "insidious" purpose of ensuring that all
people have access to the services, information, and tools they need to
prevent the next new HIV infection. 

The thought of this was again too much for CRS, USCCB, and apparently for Mark Dybul, who in the last
few weeks was reportedly working on guidance that would have made the
conscience clause even more restrictive than the law (as he has done
with the abstinence-until-marriage provision, the prostitution pledge
and every other element of PEPFAR criticized by experts across the

To help his friends, not only did Dybul begin drafting more restrictive guidance, underscoring that groups would no longer need to refer to nor partner with other programs to ensure individuals got everything they needed to protect themselves, but he went to Congress several times this month to make a case for this!

Without permission from the White House!

(Was he on the ballot in November?  I can’t remember.  Or is he just answering to a higher power?)

Dybul, who may have gotten a little full of himself up there at OGAC with all that money at his disposal, seems to have been free-lancing in trying to head off efforts in the new Congress to moderate the public health and human rights abuses inherent in a conscience clause that actually denies people at risk evidence-based information.

Secretary Clinton knew exactly what she was doing and why it needed to be done.

Dybul defenders?

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  • invalid-0

    Bravo! Thank you Jodi for your precise and important analysis.

  • invalid-0

    Thanks Jodi, you’re right on the mark!
    I remember a TV program I was on with one of these extremists who actually told me that People living with HIV should either marry themselves or remain celebate for the rest of their lives.
    If in a sero-discordant marriage, they should seek alternative ways of expressing their affections without sexual intercourse!

  • invalid-0

    No wonder that Bush religious conservatives like Mark Gearson at the Post are all in a twist about Dybul’s departure. He was apparently the “inside guy” for these religious groups that got to use PEPFAR as their personal ideolgoical slush fund! Great reporting!

  • invalid-0

    I dunno Jodi – “it has now become the cause celebre to fault reproductive health and prevention advocates for causing Dybul’s dismissal” sounds pretty good to me. Let them fault till they are blue in the face – we are on the right side. You personally should get some kind of award just for your role in exposing this shameful situation.

    In some quarters, sunlight is still the best disinfectant.

    And screw Mark Gerson. He’s just another political operative hiding behind a carefully constructed political “character” – the compassionate conservative. It’s his shtick, his meal ticket. The Post loves him because they think they look better for having him – more “faithy.” On numerous occasions both parties have made it perfectly self-evident that the last thing they care about is saving lives.

  • invalid-0

    I’m no Dybul defender but you sure are a Clinton collaborator.

    First, you tie “some right-wing conservatives and some AIDS treatment advocates” in opposing Dybul’s dismissal (and then never mention the later groups again). The fact that they agree on something may be cause for deeper thinking.

    It’s not “some;” it’s pretty much all advocates (look at the list that signed the letter to Clinton!) AND the Lancet Editorial board separately asked for process instead of arbitrary firings (after re-hiring) and inside-baseball hirings. The advocates don’t decry Dybul’s firing. They ask for a transparent, inclusive and participatory process for decisions at PEPFAR (after years of the opposite). We don’t want a similar version of Bush’s management style.

    Many of us don’t think Dybul should’ve been asked to stay on in the first place but it’s demoralizing for pepfar to have this on-off situation in ONE week. We actually care enough about the millions of people suffering from AIDS that we don’t care about the personalities; we care about the process.

    You don’t cite a single source (of course). But why don’t you ask your source when HRC offered the job to a compliant Clinton Foundation collaborator (conflictOinterest!). Clue: it was BEFORE Dybul supposedly lobbied the Hill) and deserved this firing.

    I actually like who she picked but he’d be totally tainted by this totalitarian approach. This should be an open process with stakeholder input.

    Only one person has been interviewed for the pepfar job. 1

    And he got it! (what are the chances?)

    Is that what you want for the most highly technical and important (literally live-saving) jobs in the USG?

    Please think critically and put the Koolaid down before you regurgitate what the shadow Clinton administration tells you to report.

  • jodi-jacobson

    I am deeply confused by your post.  This blog has nothing at all to do with process.

    And it is true that the far right AND "some" AIDS Advocates are pointing fingers at women’s rights advocates who…surprise!!!! ….are HIV and AIDS advocates.  This is part of the general problem.  We have a continued, unfounded split in the way we look at HIV and reproductive and sexual health.  There should be no division between HIV and women’s rights advocacy.

    But I find the whole thing about Dybul a bit elitist.  Point me to a cabinet post where the Bush appointees remain while others await confirmation?  This is why we have BOTH poiltical appointees and expert career officials….so agencies run between appointments for one thing.  It is an insult to the many people within the agencies who themselves are relieved to see this era end to say that Mark Dybul is the only person who made the program tick.  Methinks perhaps you are drinking HIS Koolaid.  

    I have no problem with whether or not the State Department runs a process, but it would be unusual and out of sync with every single other appointment, so why in this case is PEPFAR special?  Why are other Presidential appointments different?

    And as for highly technical and important jobs….sorry, Mark Dybul was not much known before he got the job by the very accident of having Randall Tobias invite sex workers to his apartment.  I think there are many people qualified to hold the job, and a full agency of professionals to hold down the fort til whomever it is is selected and in place.

    It is just not that big a deal.



  • invalid-0

    I’m sorry to point this out, Jodi. But you need to do a bit of fact-checking in your post. Randall Tobias resigned as USAID Administrator in 2007. Dybul was sworn in to head PEPFAR in 2006. The two developments were not related. Your claim “Mark Dybul was not much known before he got the job by the very accident of having Randall Tobias invite sex workers to his apartment” is simply inaccurate. Time for a quick RH Reality Check.

  • invalid-0

    “This blog has nothing at all to do with process.”

    I know. And that’s the problem. Obama was elected (and Hillary defeated) precisely because he had a grass(net)root process and this continued in the transition with change.gov

    This is about process, transparency, inclusion and participation by stakeholders.

    Everyone who cares about human suffering (as we all do) should care about this job and we shouldn’t be manipulated by politicians (of any stripe) to accept THEIR choice. We can make the choice and they can implement it, sort of like a democracy.

    “There should be no division between HIV and women’s rights advocacy.”

    Amen, so let’s work together to make this position (unlike under Bush) an apolitical, consensus choice supported by all of us who truly care about the mission of pepfar.

    “Point me to a cabinet post where the Bush appointees remain while others await confirmation?”

    Gates- Defense and others (sub-cabinet). I’d’ve not kept Dybul (interim would’ve been fine) but there’s no way you ask him to stay and fire him (and don’t believe the story of his lobbying; it’s not true).

    I’m no Dybul defender (and said so). But recognize that no one could’ve done the job under Bush. He was the only gay person in the admin. He did as best as could’ve been done in a faith-based, anti-intellectual and anti-science envirionment.

    “why in this case is PEPFAR special? Why are other Presidential appointments different?”

    Are they serious questions? Compared to the ambassador to san marino? Really? If you don’t think pepfar is special why aren’t your writing about who’s going to be head of protocol in State? $6 billion a year to save lives and what’s special about that?

    “It is just not that big a deal.”

    I think the millions of lives in the balance are a big deal. The best person for the job is important. I won’t just accept who Ira Magaziner and the Clinton Foundation says will be best for them.

    Who are your sources? Do they have an axe to grind?

    Don’t let them divide us. Now, more than ever, let’s make a united voice . . . so all our voices are heard:

  • jodi-jacobson

    I mixed up the the timing of the transition.

    Tobias was Global AIDS Coordinator until he became the first United States Director of Foreign Assistance and concurrently as the Administrator of USAID. 

    The point is the same.  Tobias was Global AIDS Coordinator until he took the post above.  Dybul worked under him at OGAC.  Dybul was little known outside that sphere until he became Administrator.  But this just underscores my point.  Agencies are full of people who can step in either as Acting or be selected as the head of an Agency, if they are chosen to do so.  Dybul has proven himself to be an ideological flack.  I see nothing at all here to disprove his record.

    The major difference is that if I make a mistake I take ownership and responsibility.  




  • jodi-jacobson

    As someone who has been a leader of coalitions and on boards of directors and subject, as a participant to others in both positions, I know that there is a time to process, and a time and a LEADER to make a decision.

    Gates was kept on because he was deemed to be the best person for the job. He is not interim; he was asked to stay on. 

    I do not think that Dybul is special, I do not think he is the only and certainly not the best person to lead PEPFAR, I do not think the people under him are incapable of running the program while an interim is found, and I have not said anything here about not running a process. I have just pointed out a political fact.  Indeed I wrote a separate blog ABOUT the process on the front page of this website.

    And no, the people from whom I collected these facts do not have an axe to grind.  There are enough sources who know.  Moreover, this is just more of the same from Dybul.  Those who want to defend him no matter what are not exactly listening with the open ear for which they are asking others, to the people in the field who have suffered under this policy for years.  

    Thanks again, Jodi


  • invalid-0

    So, leadership is rejecting someone’s proforma resignation and saying you want them to stay on for the good of the mission. Then demanding they resign again (and clear out their desk by that afternoon). And these leadership decisions are made in the space of less than one week.

    Leadership is also interviewing EXACTLY one person for a position that oversees $6 billion a year and saves millions of lives. And then offering the job to that person (and then firing the guy you’d asked to stay on).

    I know what leadership is (and this ain’t it).

    I also know what blind followship is.

    We are the change we’ve been waiting for and we, the people, are the leaders now. We don’t wait compliantly for them to tell us what to do.

    It’s a whole new paradigm and oldtime politicians don’t get it.

  • jodi-jacobson

    Do you mean Annoyed Mouse?

    I must say this post and the one above it are annoying me.

    1) No, I do not think PEPFAR is any more special OR "exceptional" than is running HHS, State, Defense, or numerous other agencies in which many millions of lives are at stake every day.  To me, every existing life is precious.  (And please, let’s not get into an anti-choice melee here, as I am not talking about zygotes or fetuses).

    2) People are fired every day.  Dybul was asked to stay on before Secretary Clinton was confirmed, and apparently without her knowledge.  She runs the State Department whether you like it or not, and she was CHOSEN without a process by the President, and confirmed by the Senate, and Mark’s successor at OGAC will have to go through the same process as everyone else.  I personally do not see the point, having spoken with many people on this issue, of pressing a special case for PEPFAR over HHS, Defense, State, etc.  Please do not insult my intelligence as I was not speaking of the Ambassador to San Marino, and I would hope you had the smarts to know that.

    3) I know personally of at least 10 names that have been floated for this position since September.  I know many of us expected Dybul to go on day one.  Secretary Clinton had to be confirmed.  To talk about sub-cabinet appointees again is to prove my case….an ideologically identified leader goes when the Administration changes.  Sorry,..this is real life.  I don’t care if he was gay, straight, purple, black or a maraschino cherry.  He was ideological.  he put himself before people at risk of HIV.  He lobbied—and I know this for absolute fact—to make PEPFAR 2 MORE RESTRICTIVE.  He was not "suffering the problem," he was part of it.

    And oh….the process thing…..Dybul was the least process friendly Administrator I ever saw, especially if you agreed with GAO, IOM, Columbia University, and many, many others that the abstinence-until-marriage provision had been turned into abstinence-only programs on the ground, and that funding was going to wackos.

    So really….this is a going-nowhere argument.  he is gone.  I spill no tears.  The program continues.  The good people of State, USAID, CDC, HHS, and the missions will ensure this happens…his cronies will be replaced with real public health professionals, quickly, I hope, and we will move on.

    The melodrama is not really worth the effort.



  • invalid-0

    Actually meant anony(ed)mous(e) as it comes up in the field but it would’ve been a riveting expose of the utter fallacy of my contrived polemic . . . if you’d actually found a typo. Bravo

    If pepfar’s no more important than any other state appt, please let’s hear your analysis of ambassador to guinea bissau or any other ambassadorship (you do know that the head of pepfar is an ambassador, right?).

    People are fired every day but rarely re-hired and fired in the same week (once by a guy called the prezOUSA and then overruled by HIS secOstate, former opponent and wife of former prez). Sorry that’s not every day

    She runs State FOR Obama (not herself or her hubby). Obama was elected BY us (and actually works for us). She doesn’t get to put Chelsea in as head of pepfar, just because she can. You’re thinking monarchy . . . three centuries ago. We actually do get to disagree with this (really). No heads are cut off (don’t be scared).

    10 names floated? which names? By whom? Who was actually interviewed (do you even care, you just trust this nonprocess)?

    And because Dybul was against process we should be. Because we’re against what he stood for. Good point. Got it. That’ll show him.

    That way when there’s a republican admin next time they’ll have to do a process just because we’ll’ve shown them that we don’t have to.

  • jodi-jacobson

    I asked about the spelling to make clear you were not another poster, as we have numerous configurations of the "Anonymous, Anonymouse," etc on this site for those unable or unwilling to identify themselves.

    I won’t engage the issue of to whom I am comparing Dybul; I have stated this before.  His position is equivalent to that of any other leader of a large agency in the government and is being treated as such.  The title really is superfluous.

    And really….I am sorry…get a life.  He was not "re-hired and then fired."  That may be his story.  He claims to have been asked to stay on indefinitely and sent around an email.  If you know anything about politics and the process, there were any number of names floated for any number of positions put out there, including for example Richardson for Commerce, that either go nowhere, get withdrawn or don’t get confirmed.  This is real life.  Unfortunately, Dybul is not special or immune.

    If you want to fail to see the reality of the situation, he serves or does not at the pleasure of the Adminstration.  Period.  He can be hired at 8:00 am and fired at noon for whatever reason.  This actually happens every day….are we as worried about the millions of people without the resources Dybul has that are losing their jobs every day?  Please.

    The Secretary of State had not yet been confirmed.  The Obama White House and the Secretary of State get to make the decision.  They made the decision when they made it.  He was, as I have reported and apart from other things, caught doing things he should not have been doing.  Like I said: He is gone.  Their decision.  From my vantage point it is a good thing.  My prerogative. Your prerogative to be pissed.

    Real work must be done so I leave it at that.


  • jodi-jacobson

    please see this blog post….written before the one to which your comments are attached.



  • invalid-0

    President Obama recently abruptly reversed his decision to keep Global AIDS Coordinator Dr. Mark Dybul at his post and working as the new administration gets on its feet. Originally Obama intended to have Dr. Dybul remain at work until such time as his replacement could be selected and confirmed. On the day after inauguration day, however, Dybul was unceremoniously dumped from his role. He was asked to resign in the morning and was out the door by 3PM.

    The Washington Post op-ed, which has been confirmed by many sources, points out what a catastrophe this really is:

    While I worked at the White House — from 2001 to 2006 — I saw Dybul combine the ability to build bipartisan consensus for PEPFAR on Capitol Hill with exceptional compassion for the victims of a cruel and wasting sickness. It mattered little to the Bush administration that Dybul was openly gay or that he had contributed to Democratic candidates in the past. He was recognized as a great humanitarian physician — a man of faith and conscience — almost universally respected among legislators, AIDS activists, foreign leaders and health experts.


    Then, the day after the inauguration, Dybul received a call asking him to submit his resignation and to leave by the end of the day. There was no chance to reassure demoralized staffers, or PEPFAR teams abroad, or the confused health ministers of other nations. The only people who seemed pleased were a few blogging extremists, one declaring, “Dybul Out: Thank you, Hillary!!!”

    As in most political hit-and-run attacks, the perpetrator was not anxious to take credit. It seems unlikely to be Hillary Clinton herself — Dybul’s ultimate boss at the State Department — who had not even been confirmed when Dybul received his call. But someone at State or the White House determined that sacrificing Dybul would appease a few vocal, liberal interest groups. One high-ranking Obama official admitted that the decision was “political.” Yet the AIDS coordinator is not a typical political job, distributed as spoils, like some deputy assistant position at the Commerce Department. It involves directing a massive emergency operation to provide lifesaving drugs, through complex logistics, to some of the most distant places on Earth. And now that operation may be months without effective leadership — undermining morale, complicating interagency cooperation, delaying new prevention initiatives and postponing budget decisions.

    The extremist groups who apparently applied the pressure here attack the Ambassador on the completely false grounds that he advocates abstinence only education programs. It’s a dramatic falsehood, designed by that particular brand of rabid left-wing group that sees the world through rage-red “anybody but Bush” glasses. Their deliberately false ranting is predicated on the preposterous notion that Dr. Dybul is a “misogynist” and “anti-condom” because his comprehensive, widely lauded, hugely successful President’s Emergency Plan for AIDS Relief (PEPFAR) was, in point of fact, comprehensive. As in, in addition to distributing condoms (2.2 billion of them in fact), foreign aid and assistance, and education programs, they also include education on abstinence and fidelity.

    Also, there are internet rumors that he’s friendly with dreaded madman and Obama invocation star Rick Warren. Friendly? Heavens!!

    Under Dr. Dybul’s leadership the massive and complicated task was being more than ably handled; now the program is unhelmed. Dybul was not to remain permanently, remember, just until he could be suitably replaced. Apparently for the left-wing noise machines that simply just wasn’t good enough. Dybul had done the unthinkable: he’d worked for Bush and used the word abstinence in a sentence without the words “right wing wacko” or “backward, clinging, religious hicks” and is therefore essentially an imperialist Nazi rapist. So now we’re left to wonder how many of the people in some of the world’s poorest nations, who depend on this assistance program, are going to suffer from Obama’s weak-kneed cave-in.

    Hillary Clinton, as the Secretary of State, is ultimately in charge of the program; She will be the eventual boss of whoever eventually replaces Dybul. A source close to Mrs. Clinton confirmed to Political Machine today that she had nothing to do with the ouster, and was not aware of it until after her confirmation. (The Clinton confidant adds that the Secretary has not yet had time to react to the scandal as she has put all her attention on her upcoming international debut tour.) That information, combined with the Obama administration source cited in the Post story, places the ultimate responsibility squarely on President Obama.

    A decision was made to pander to extremist activist groups rather than to do what is right. The decision places AIDS sufferers and at-risk people in poverty-stricken Africa in jeopardy for the sake of what can only be a very small political gain for President Obama. Putting partisan political gain ahead of sound decision-making, especially where the health of thousands is at risk, is scandalous in every case. But to do so to satisfy loud-mouth left-wing bloggers and extremist activist groups willing to sell-out anyone in their quest to abolish the word abstinence from the English language is despicable. To do it by sacrificing a generous, openly gay, HIV-specialist, a Doctor who has spent the last several years doing more to prevent the AIDS epidemic in Africa than those pathetic little complaint club activists groups ever have or ever will is just downright pathetic.

  • invalid-0

    Whilst “Consultant” Jacobson spends her days and nights in the blogosphere, adults in the real world actually do things and run things.

    Dybul appears to be one such person, but Consultant Jacobson has smeared him with un-sourced allegations.

    “Dybul was found on the Hill lobbying for a more restrictive interpretation of the PEPFAR conscience clause than currently exists, with the intention of placating the Catholic Church.”

    Jodi — found by whom? any sources? anything on the record except your say-so?

    “(Seriously…I was at a conference in Abuja, Nigeria where it was suggeted (sic)by PEPFAR-funded faith based groups that these couples, rather than using condoms, simply “find other means of expressing marital love than through physical affection….for the rest of their lives.”)”

    Jodi — nice anecdote, but can we all agree that, if true, this is an aberration?

    “To help his friends, not only did Dybul begin drafting more restrictive guidance, underscoring that groups would no longer need to refer to nor partner with other programs to ensure individuals got everything they needed to protect themselves, but he went to Congress several times this month to make a case for this!

    Jodi — whoa….again, any sources, evidence, anything in/on on the record…..or just your say-so? This does not ring true to me.

    You are doing no one a service my making things up. Grow up. Get a day job.

  • invalid-0

    “..He was, as I have reported and apart from other things, caught doing things he should not have been doing.”

    Caught? By whom? Any evidence or shall we just take your word for it?

    This is dishonorable. You destroy your credibility with this sort of “reporting.”

    Shame on you.

  • invalid-0

    “Reporting” ??? NOT.

    This is unsourced and unverifiable innuendo by a blogger.

  • invalid-0

    “women and youth—the groups most at risk in the AIDS epidemic—”

    Really now? When was the last time you read a epi-profile of the HIV epidemic? MOST at risk? I agree about Dybul, but please do some fact checking or limit the grandiose blanket statements.

  • jodi-jacobson

    You have picked the wrong people to challenge on this, and you really should check your own facts before you challenge mine.  A quick google search of such obscure sites as the World Health Organization, UNAIDS, PEPFAR, and CDC are among the few I would suggest you peruse.

    But to help you out a bit…..

    In 2002, women represented the half of all cases of HIV infection globally and the rates of infection among women have continued to rise.

    Today, women and girls represent two-thirds of those infected in sub-Saharan Africa.  According to UNAIDS a couple years ago, "Recent surveys reveal that in South Africa, Zambia and Zimbabwe, young women (aged 15-24) are five to six times more likely to be infected than young men of the same age." 

    From UNAIDS: Some 7,000 girls and women become infected with HIV every day.
    In most regions, women and girls make up an increasing proportion of
    the population living with HIV, and rates of female infection continue
    to rise – particularly in Eastern Europe, Asia and Latin America.

    Examples from a few UNFPA country reports


    As a result of the increased scale up of HIV related services, the overall HIV
    prevalence rate has decreased in recent years. However, young women and
    girls in Kenya remain particularly vulnerable to HIV, due to persistent gender
    inequality and a lack of economic opportunities for young women and girls. 


    Young women, and girls in particular, are disproportionately affected
    by the epidemic. Numerous obstacles contribute to the vulnerability of
    young women and girls to HIV. These include cultural and religious
    factors, which can decrease respect for women’s legal rights and access
    to key services.


    Nearly half of Malawi’s population is under 15 years old. In 2005,
    prevalence among females aged 15-24 was four times that of males. The
    many factors that increase girls’ and young women’s vulnerability
    include a lack of knowledge about prevention methods (with only 57.3%
    stating that condoms can help prevent HIV).


    Over 40% of Nigeria’s population is under 15 years old. Young people
    account for over 30% of HIV cases, with prevalence nearly three times
    higher among 15-24 year old females than males. The many factors that
    increase girls’ and young women’s vulnerability include early marriage,
    early sexual debut, polygamous relationships and multiple partners.

    In the US, according to CDC in 2007,

    In 2004 (the most recent year for which data are available), HIV infection was the leading cause of death for black women (including African American women) aged 25–34 years; the 3rd leading cause of death for black women; aged 35–44 years the 4th leading cause of death for black women; aged 45–54 years the 4th leading cause of death for Hispanic women aged 35–44.

    For exhaustive data on youth, please see the websites of Advocates for Youth, and SIECUS, to name just two.

    Example from AFY:

    HIV/AIDS seriously affects adolescents throughout
    the world. One-third of all currently infected individuals are youth,
    ages 15 to 24, and half of all new infections occur in youth
    the same age.1 More than five young people
    acquire HIV infection every minute; over 7,000, each day; and more
    than 2.6 million each year.1

    I could go on, but I don’t believe in doing all of people’s homework for them.

    Hoping you are not working on HIV prevention….






  • alexm

    You are my favourite political analyst!! 

    The personal is political.

  • invalid-0

    RH Reality Check encourages open and honest debate about the issues on which we report and cover. It is certainly within a commenter’s rights to question facts and issues raised by our writers and bloggers. 

    However, if you must resort to name-calling in order to make a point, please know that this undermines no one’s credibility but your own. 

    In addition, RH Reality Check stands by Jodi’s statements 100% because of her thorough reporting, credible sources and expertise in this area. Feel free to comment with your own conclusions drawn but Jodi has spent more time and energy on these stories and on HIV/AIDS prevention work than most people. Her work is impeccable and RH Reality Check is proud to stand by it. 


    Amie Newman

    Managing Editor, RH Reality Check

    • invalid-0

      How can you do so when the statement are not sourced, and when JJ offers no independent verification or any on the record quote from ANYONE. Show us the EVIDENCE that Dybul was on the Hill lobbying as she claims. Who, when, where, etc.? Absent that, much of this is libelous or at the very least unfair. Let’s have it.

  • invalid-0

    Editor, 100%?

    I guess that’s why you didn’t even bother to edit her article or ask her any questions about these ‘sources.’ Did she try to ask Dybul HIS side (be nice before slandering him, don’t you think)? The congressional offices he was supposedly lobbying?

    Are you covering her journalistic butt or yours editorially?

    She’s 100% wrong about various things she’s said (and even admits some). No one had been asked by Obama to stay on from Bush’s admin? Completely wrong about Tobias and when Dybul even started the job. Didn’t know it was an ambassadorship. The list goes on . . .

    Just use the Find option and look at all the unanswered questions using “?.” Like which 10 folks were floated and by whom.

    And did I insult her in any way? She’s telling me to ‘get a life’ (which is teenage for insult) for having the nerve to question her source. Did you think that was called for?

    Next time go ahead and be a critical-thinking editor and back the truth 100% not a fallible person (as we all are). Because your intervention here is painful proof that the story doesn’t stand on its own and needs the willing suspension of disbelief to be credible.

  • jodi-jacobson

    That OGAC is an Ambassadorship.

    Nowhere did I say I was not.  You are twisting my words. That would seem to be your MO.

    I reject(ed) the snyde comparisons you made to Guinea Bissau, and you or some other person made to San Marino.  My point is, was, and always has been that Ambassadorship or no, the President and the State Department decide this post, and the process is one that is consistent with all others.  I never made these nonsensical comparisons, you did.  My comparison to HHS, State and others is to point out that no, I do not think that OGAC is a "special case" as you are making based on the claims above that it spends billions and deals with saving lives, as these other agencies do the same, and their leadership underwent the same process.  Maybe this is why you folks still can’t get the fact that comprehensive programs for individuals can not be broken down into isolated component parts and still be comprehensive. 

    Keep in mind that no commissions were convened in picking other Ambassadorships, such as that of Ambassador Susan Rice, with portfolio over many areas including Darfur, which also is the subject of life and death struggle.

    I do not object to your lobbying for a process; I merely stated my own opinion on whether it was a good strategy or one likely to work.

    My sources are fine, my knowledge of these issues extensive, I was there when Dybul and others were putting the more restrictive conscience clause into law in the first place.  The abstinence-only program framework is in the original guidance and well documented.  The fact that he made the prostitution pledge more restrictive than the law is evident.  if you bothered to read the cooperating agreements (I have) disaggregated the funding streams (I and many others including GAO have), gone on the ground (I have) and been objectively and critically reviewing this program since 2003 (I have) ….you might be better informed.  He also, on paper, for your viewing pleasure wrote guidance denying PEPFAR funding for contraceptives to HIV positive women….a piece of policy NOT required by law.

    The evidence of Dybul’s need to pony up for the far right and to undermine prevention to keep in good stead with those who see an ideological cash cow in PEPFAR is well-documented, by me, but by many, many others.

    And yes, as I noted above, I did mistake the timing of the transition, but I am not afraid to admit mistakes, unlike the many who defend Dybul.  Don’t spin your web from there, as there are no others.

    Thanks again for writing.  Jodi

  • jodi-jacobson


  • invalid-0

    Some trolls seem to assume that just because Dybul is openly gay that he has to be liberal in his interpretations – not so, after all their are lots of gay guys in the Catholic Church – most of them priests! And there are lots of gay guys who subconsciously demean and discount women – After all look at the feminine images created by fashion designers… Stereotypical misconceptions abound… Dybul’s behavior with respect to HIV policy is the key – and separating HIV prevention from basic contraceptive and reproductive health services is the most egregious of sins.

  • http://www.pitchingmachineshop.com/selections/jugs-pitching-machines invalid-0

    There are quite a bit of controversial thoughts and discussions in this article. Regardless of who’s right or wrong, i think we should give Jodi credit for her hard work. She has done an amazing job!


    • invalid-0

      I do agree that we should thank Jodi for her work; nevertheless I do have some points of contention. First, the liberal vs. conservative agenda should mutually look at AIDS in the context of third or fourth world nations deprived of basic social services and plagued by portfolios of debt and poverty. Second, while tax payer dollars should be disbursed with caution, we should understand that these AIDS-afflicted nations also rank worse in investment and portfolio reviews by the World Bank and IMF, thereby showing dismal signs of being able to cope with the problem on their own.

  • http://www.managementdynamics.info invalid-0

    Women and youth the groups most at risk in the AIDS epidemic.
    we should give Jodi credit for her hard work.Thanks for sharing.

  • http://www.managementdynamics.info invalid-0

    Women and youth the groups most at risk in the AIDS epidemic.
    we should give Jodi credit for her hard work.Thanks for sharing.