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Cruising with Lazarus
The Sad State of the U.S. Office of National AIDS Policy

By David Salyer

October 2002

Sometimes, when I think a particular word is being used incorrectly to describe something or someone, I like to refer to my dictionary for clarification. Take, for instance, the media's nonsensical name for the person appointed by the president to direct the Office of National AIDS Policy: AIDS czar. If you look up czar (pronounced zar) in your dictionary, you will likely find the same four definitions I did ... an emperor or king ... the former emperor of Russia ... an autocratic ruler or leader ... any person exercising great authority or power. "Czar" hardly describes Scott Evertz, the man tapped by President Bush to head the Office of National AIDS Policy in April 2001. Fifteen months into his appointment, America's AIDS czar was dethroned last July.

Bush's appointment of Evertz marked the first time a Republican president had named an openly gay person to a high-level administration job. At the time of his appointment, Evertz was president of the Log Cabin Republicans of Wisconsin, a gay GOP group, and employed as director of resource development for the United Lutheran Program for the Aging, a faith-based program for seniors in Milwaukee. He also worked as a fundraiser for Wisconsin Right to Life (an anti-abortion group) and a Milwaukee faith-based organization called Common Ground, which operates a housing program for people with AIDS. Frankly, nothing on his resume qualified him to assume a significant leadership role within the Office of National AIDS Policy.

Research on Scott Evertz, turns up vague references to AIDS-related experience -- an official government biography claims he was a public policy advocate in the state of Wisconsin for people living with AIDS, and that he purportedly worked closely with then-Governor Tommy Thompson to create "one of the best service delivery systems in the nation for people living with HIV/AIDS." Some sources report that Evertz has worked on gay and AIDS issues pending before the Wisconsin legislature since the 1980s, but I was only able to confirm that he played a key role in persuading the Wisconsin legislature to pass a law in 1997 ensuring hospital visitation rights for partners of gay patients.

By all accounts, Scott Evertz is a very nice man, but the hard truth is that he lacked the kind of Washington intergovernmental connections you need for a leadership position and he was never able to develop a national profile in his White House post. Break it down and Evertz is simply a gay Republican and a professional fundraiser for some Wisconsin-based nonprofit organizations with a B.A. in Theology and Political Science from Milwaukee's Marquette University. He's not a doctor, he has no public health credentials, and he's never run an AIDS service organization. While I appreciate the fact that he's openly gay, his sexual orientation alone does not eclipse his rather obvious lack of qualifications.

The appointment of Scott Evertz was all about the fact that he developed some arbitrary political ties to Wisconsin governor Tommy Thompson, whom George W. Bush named Secretary of the U.S. Department of Health and Human Services. Thompson recommended Evertz to Bush, and Bush, whose original plan was to shut down the Office of National AIDS Policy after being appointed president, stuck Evertz in the post only after AIDS activists balked at his proposed elimination of the position and the office.

Plenty of gay rights groups and AIDS organizations hailed the appointment of Evertz as groundbreaking based primarily on the fact that a conservative Republican president chose an openly gay man. However, I've yet to understand what's so groundbreaking about Bush selecting an unqualified gay man for a position he wanted to eliminate anyway and had no intention of acknowledging since his administration's official, public policy on AIDS is that abstinence and monogamy are the solution?

How big a failure was Scott Evertz as Director of the Office of National AIDS Policy? His public appearances lacked relevance. In February of 2002 he addressed the Atlanta Executive Network, a gay and lesbian business organization, but when asked to name his top five AIDS policy priorities he "couldn't think of any at the moment," but later joked that he was "still uncomfortable with the title 'AIDS czar,' especially because it didn't come with the requisite tiara." (Source: Southern Voice, 3/01/02) Not bad enough for you? Consider that Evertz, a professional fundraiser, accepted a position as the nation's top advocate for people living with HIV and AIDS, but failed two years in a row to convince the Bush administration to increase funding for the Ryan White CARE Act program or the Centers for Disease Control's HIV prevention programs. And what does he have to say about that? "Everyone who has a seat at the table, as I did during the budget discussions, was arguing fiercely for their programs, "Evertz said. "So I, in the midst of conversations about cutting programs, argued fiercely for not going backwards. That was my position." That's not a fundraising tactic; that's inertia.

Mercifully, Tommy Thompson, Secretary of the Department of Health and Human Services removed Scott Evertz from the Office of National AIDS Policy in late July, appointing him as special assistant to the Secretary to work on further developing and implementing the department's overall strategy to fight HIV/AIDS around the world, including the Global Fund to Fight HIV, Tuberculosis and Malaria. In other words, Scott Evertz has been sentenced to bureaucratic oblivion where his incompetence will evade public scrutiny.

Bush has already named a new director for the Office, Dr. Joseph O'Neill, a gay physician who, prior to this appointment, was Acting Director of the Office of HIV/AIDS Policy at the U.S. Department of Health and Human Services and Director of the HIV/AIDS Bureau of the Health Resources and Services Administration, the office responsible for management of the $1.9 billion Ryan White CARE Act. Dr. O'Neill is a practicing HIV/AIDS physician and a volunteer member of the faculty of the Johns Hopkins School of Medicine in Baltimore. Dr. O'Neill holds degrees in business administration, public health, medical sciences, and medicine from the University of California and has been treating HIV/AIDS patients since the early 1980s.

As the government's chief administrator of the Ryan White program, a physician, and the former medical director of the Chase Brexton Clinic, an organization established to serve the gay and lesbian community that evolved into a large provider of AIDS services in Baltimore, O'Neill is dramatically more qualified than Scott Evertz ever was. You almost wonder why O'Neill, a man who held a variety of Health and Human Services posts wasn't selected in the first place. On the surface, it looks like the Bush administration is upgrading the position of AIDS czar by appointing a physician with public health credentials who knows the federal AIDS bureaucracy.

Now let's break it all down again. O'Neill is openly gay which means he's already despised and soon to be vilified by every rabid, conservative group in America the first time he promotes safer sex, condom use or needle exchange programs as legitimate HIV prevention methods. AIDS service organizations will ignore him and AIDS lobbying groups will feel betrayed unless he advocates comprehensive HIV prevention programs. Meanwhile, as Director of the Office of National AIDS Policy, O'Neill's actual job is to work with federal agencies and coordinate the development of HIV policy for the White House, but the White House, already bowing to pressure from right-wing groups seeking abstinence-only education programs, isn't listening. Under such circumstances, how can Dr. Joseph O'Neill possibly impact national AIDS policies?

The Office of National AIDS Policy (ONAP) was created in 1993 by President Bill Clinton as a branch of the Executive Office of the President. At the time it seemed like a big deal. Dr. Joseph O'Neill is the sixth individual named Director of ONAP in less than ten years, following Kristine Gebbie, Patricia Fleming, Eric Goosby, Sandra Thurman and Scott Evertz. Most promised aggressive HIV prevention and education for America. Several quit after complaining of conflicting agendas and lack of support. What do they all have in common? The organization they were chosen to head is a public relations shell functioning primarily to create the illusion of a grand strategy in the war against AIDS.

Bill Clinton, bless his heart, may have actually believed he'd created something vital and important, but George W. Bush was on the right track when he originally planned to eliminate the White House Office of National AIDS Policy. Decisions that affect HIV and AIDS policies will continue to be made by the Congress, the National Institutes for Health, the Centers for Disease Control, the Food and Drug Administration, state legislatures, and the Department of Health and Human Services -- not by an AIDS czar.

Forgive my skepticism, but it is highly unlikely that Dr. Joseph O'Neill will be any more successful than his five predecessors despite his knowledge of the virus, the affected communities and his undeniable capacity to do the job. The cheapest and most effective way to stop AIDS is to keep people from getting infected. But prevention requires straight talk about sex and condoms and microbicides and clean needles -- the kinds of things that make people, especially politicians like George W. Bush, squirm.

If Dr. Joseph O'Neill called a press conference and demanded a repeal of the congressional ban on needle exchange programs, challenged lawmakers to pass the Microbicides Act of 2002, and denounced the CDC for its politically motivated audit of sexually explicit HIV prevention programs designed for gay men, then the existence of a so-called AIDS czar might be worth the expense to the taxpayers. But the White House will never give Dr. O'Neill the latitude to say those things, and if he did, well, enter AIDS czar No. 7.

Got a comment? Write to David at Cubscout@mindspring.com.




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