Why the Presidential Advisory Council on HIV and AIDS Should Be Disbanded

Back in 1995, President Clinton, Vice President Gore and Health and Human Services Secretary Donna Shalala established the Presidential Advisory Council on HIV and AIDS (PACHA). Made up of 35 members, including an executive director and chairperson, PACHA is supposed to be comprised of people with particular expertise in, or knowledge of, matters concerning HIV and AIDS -- authorities. These experts would provide recommendations on the U.S. government's response to the AIDS epidemic.

According to the Presidential Advisory Council on HIV and AIDS Web site (www.pacha.gov), PACHA "provides advice, information, and recommendations to the Secretary regarding programs and policies intended to promote effective prevention of HIV disease, and to advance research on HIV disease and AIDS. The role of the Council is solely advisory in nature. The Secretary provides the President with copies of all written reports provided to the Secretary by the Advisory Council."

Clinton, Gore and Shalala meant well. It must have sounded like a great idea at the time. After all, Presidents Reagan and the first Bush largely ignored HIV, demonstrating an arrogant indifference to the mortal virus even as it evolved into a pandemic. Now, less than eight years after its creation, the Presidential Advisory Council on HIV and AIDS is an unqualified fiasco. Under the current Bush administration, PACHA has become a perverse oddity populated by ultraconservative, religious zealots like Patricia Funderburk Ware and Tom Coburn, folks whose personal squeamishness about sex and extreme evangelical Christian views undermine any kind of substantive dialogue about HIV prevention.

Tom Coburn, M.D., PACHA co-chair, is a former U.S. House Republican who went Chicken Little back in 2001 after reading an analysis of 138 condom studies released by the National Institutes of Health (NIH). The report concluded condoms work well in curtailing transmission of HIV and gonorrhea, but only so-so in preventing other sexually transmitted diseases (STDs). Coburn, who moonlights with ultraconservative groups like Focus on the Family and Family Research Council, overreacted spectacularly, saying, "This report means that when condom use is discussed, it is no longer medically accurate or legal for the CDC to refer to sex as 'safe' or 'protected.'" And then, like all hysterical right-wingers, he had to call for someone's resignation, in this case former Centers for Disease Control (CDC) director Jeffrey Koplan, M.D. What made this all the more ridiculous is that those of us working in HIV prevention have always known that condoms do not necessarily prevent transmission of all STDs. Some STDs, like chlamydia, genital warts and genital herpes can be present on the skin, which makes skin-to-skin contact a problem. Condoms can reduce the chance of infection, but not eliminate it. Tom Coburn is a medical doctor! He ought to have known the lowdown on condoms already, and if he didn't know and was actually surprised by anything in that NIH report, then you have to question his intelligence. Unfortunately, Coburn's appointment to PACHA has given him a platform for his anti-condom, abstinence-only agenda.

Patricia Funderburk Ware, PACHA's Executive Director, is a veteran of the first Bush administration, serving as Director of the Office of Adolescent Pregnancy Programs at the U.S. Department of Health and Human Services. She is also the former Director of Educational Services for Americans for a Sound AIDS/HIV Policy. Like Coburn, Ware is an outspoken critic of condoms who habitually promotes abstinence until marriage as the only acceptable guideline for sexual conduct. Worse than her crusade against sexual information and education is the fact that Ware once lobbied against including HIV and AIDS in the Americans With Disabilities Act and its protections against discrimination. Mainstream media sources routinely refer to Coburn and Ware as controversial, politely skirting the fact that both are simply reprehensible, narrow-minded boobs.

Recently, Ware invited a man named Jerry Thacker to join PACHA. Thacker is a frightening, fundamentalist caricature with jaundiced views -- he thinks gays can be "rescued" by Jesus Christ and calls AIDS a "gay plague" -- making him a wildly inappropriate choice for any kind of governmental advisory position. Fortunately, swift opposition to his proposed appointment led to his own withdrawal. Thacker says publicly that the controversy would make it impossible for him to serve productively, but it's his own ideology that makes him unsuitable for the Council. Sure, Thacker is living with HIV -- he says his wife passed it on to him after a blood transfusion back in the '80s -- but that alone does not legitimize anything he has to say. He is not deserving of a place at a table where public policy is crafted because his views are unapologetically bigoted, profoundly useless and lacking humanity.

It's disturbing that Jerry Thacker came so close to serving on a council designed to advise our president on the most effective ways to treat and prevent HIV globally. And that's really the whole problem with PACHA as it's shaping up under the Bush administration -- there's no understanding of or commitment to epidemiology; it's becoming a freak show of fringe ideology, not science or sound judgment. Religious activists like Coburn, Ware and Thacker aren't really interested in epidemiology or science or real prevention efforts anyway. It doesn't matter to them that condoms are the only tangible prevention tools we have right now. They need to discredit condoms in order to promote abstinence. It's the kind of scare tactic typically associated with America's lunatic fringe.

In the aftermath of the Thacker controversy and withdrawal, Patricia Funderburk Ware left her post as executive Director of the Presidential Advisory Council on HIV and AIDS. Bush administration officials said Ware was being promoted to a more influential role in the Department of Health and Human Services. The good news is that she's leaving PACHA; the bad news is that Bush's leading proponent of abstinence-only education is now free to impose her personal ideological agenda within the Department of Health and Human Services. Judging from her history, Ware will likely proceed banning or censoring information about condoms and directing funds toward abstinence-only education across the United States and throughout the world. Her rejection of science-based safer sex education constitutes criminal negligence.

Meanwhile, back at PACHA, Bush's appointments thus far include no scientists and not one person living with HIV. Instead he found space on the council for some of his campaign contributors and more Christian-right, condom-hating fruitcakes like Joe McIlhaney, Jr., director of something called Medical Institute for Sexual Health, a Texas-based organization which provides condom-debunking information to abstinence educators across the country. McIlhaney publicly refuses to talk about condoms despite years of science showing that proper condom use saves lives.

The Presidential Advisory Council on HIV and AIDS is officially irrelevant. To disband this malignant 35-member panel would be a mercy killing.