Azar said Redfield’s scientific and clinical background is “peerless” and noted that during his two-decade tenure at the Walter Reed Army Institute of Research, Redfield made “pioneering contributions to advance our understanding of HIV/AIDS.” He also praised his more recent work running a treatment network in Baltimore for HIV and hepatitis C patients, which Azar said prepares Redfield “to hit the ground running on one of HHS and CDC’s top priorities, combating the opioid epidemic.”
The statement did not address Redfield's once-controversial positions on HIV testing during the first decade of the AIDS crisis — which a top Senate Democrat cited Monday in asking the White House to rethink its choice.
The decision had been expected since Redfield emerged late last week as the front-runner to become CDC director, a job for which he also was considered when George W. Bush was president. The position does not require Senate confirmation, and Redfield, a professor of medicine at the University of Maryland School of Medicine and a former Army researcher, is expected to be sworn in and take up his job in only a few days.
He did not immediately respond Wednesday to a request for comment.
Redfield’s main focus during his career has been chronic human infections, especially HIV/AIDS. He heads clinical care and research at the medical school’s Institute of Human Virology, which he founded with Robert Gallo, who co-discovered HIV as the cause of AIDS.
He also oversees a major program providing care to more than 6,000 patients in the Baltimore-Washington region, and more than 1.3 million patients in Africa and the Caribbean as part of the President’s Emergency Plan for AIDS Relief, known as PEPFAR. He served on Bush’s Presidential Advisory Council on HIV/AIDS from 2005 to 2009 and on advisory councils at the National Institutes of Health in earlier years.
Maryland Democrats praised Redfield’s selection. Rep. Elijah E. Cummings called him a “deeply experienced and compassionate public health physician.” And former Maryland Lt. Gov. Kathleen Kennedy Townsend, who sits on the virology institute’s advisory board, said, “It’s terrific to have someone who has been such a caring doctor, who has really treated patients and knows what they’re going through.”
Redfield, who has five children and nine grandchildren, has seen the devastating impact of the opioid epidemic from close experience, according to Townsend. “He knows how difficult it is to get treatment, how hard it is to find a halfway house,” she said, adding that Redfield has told her that hospitals should devote 10 percent of their budgets to treat addiction.
But the policies he supported decades ago have raised deep concern among some AIDS advocates because they were not considered sound public health approaches to the epidemic. The critics believe they also stigmatized those who were infected and feared being fired — and losing their health insurance.
During the 1980s, as the chief Army AIDS researcher, Redfield was a strong supporter of mandatory HIV screening for the military before effective treatments were available. Recruits who tested positive were barred from military service.
He was also closely linked to a controversial and unsuccessful effort in Congress in 1991 to require HIV testing of health-care professionals who perform invasive procedures, after a young woman, Kimberly Bergalis, contracted the virus from her dentist. The bill was introduced by Rep. William E. Dannemeyer, a California Republican who was one of the most conservative members of Congress.
In the early 1990s, while at the Walter Reed Army Institute of Research, Redfield was accused of misrepresenting data about the effectiveness of an experimental AIDS vaccine that he was supporting. The vaccine ultimately failed. An investigation cleared Redfield of scientific misconduct charges.
Sen. Patty Murray (D-Wash.), ranking member on the Senate Health, Education, Labor and Pensions Committee, focused on Redfield’s “lack of public health credentials and his history of controversial positions regarding the prevention and treatment of HIV/AIDs” in her letter to the White House. His pattern of “ethically and morally questionable behavior leads me to seriously question whether Dr. Redfield is qualified to be the federal government’s chief advocate and spokesperson for public health,” Murray wrote.
During the same period in the 1990s, Army investigators also criticized Redfield's close relationship with a conservative AIDS organization that strongly supported the vaccine and had received scientific information about it “to a degree that is inappropriate,” according to a 1993 Science article based on an extensive Army report. Investigators recommended that ties between Army researchers and the group “be severed so there is not an appearance of endorsement or favoritism,” Science reported.
The organization, Americans for a Sound AIDS/HIV Policy, was founded by Shepherd and Anita Smith, a politically connected Virginia couple who supported abstinence-based AIDS prevention. The group later became the Children’s AIDS Fund International and was among the first to receive federal funds to conduct HIV prevention work under the Bush administration’s faith-based initiative. Redfield, who early on was chairman of the organization's advisory board, continues to serve on its board.
James Curran, who led CDC’s efforts against HIV/AIDS for 15 years, said Redfield should be commended for his dedication in the fight against the virus, recalling the difficult circumstances for his research during the 1980s and 1990s.
“The disease itself was new. He was dealing with homophobia and stigma. They were big barriers, especially in the military,” said Curran, dean of the Rollins School of Public Health at Emory University. “He has remained committed to this problem, and I give him credit not only for working among the poorest of the poor in this country, but also the poorest of the poor people in the world.”
While Redfield's supporters point to his strong background in infectious disease and global health, public health experts inside and outside the agency say one of his biggest challenges will be his limited governmental public health experience, especially involving emergency responses.
Many had hoped the administration would pick Acting Director Anne Schuchat, 58, who has nearly three decades of experience at CDC and is highly regarded within the administration and on Capitol Hill. Azar thanked Schuchat for stepping in, the second time she has done so in the last year.
The Center for Science in the Public Interest said Redfield's appointment would be “disastrous.”
“What one wants in a director of the Centers for Disease Control and Prevention is a scientist of impeccable scientific integrity,” the group said in a statement Wednesday. “What one would get in Robert Redfield is a sloppy scientist with a long history of scientific misconduct and an extreme religious agenda.”
With infectious disease outbreaks on the rise, the CDC plays a critical role in detecting, preventing and controlling their spread. The Atlanta-based agency is responsible for issues including the world’s most dangerous organisms, chronic diseases such as diabetes and obesity, and birth defects caused by the mosquito-borne Zika virus.
“You want someone leading the organization who has been tested,” John Auerbach, president and chief executive of Trust for America’s Health, a public health nonprofit, said late last week. “You wouldn’t want them to spend a year of their lives learning about the agency they’re overseeing. In a crisis, we need someone who can hit the ground running.”
Former CDC director Tom Frieden noted the critical role of the agency in protecting the health of Americans. “I wish Dr. Redfield well and hope he will be an effective advocate for both funding and the scientific independence of CDC, while earning the trust and support of its world-class doctors and scientists,” said Frieden, who now heads a nonprofit, Resolve to Save Lives, a global initiative to prevent epidemics and reduce cardiovascular disease.
The job heading the country’s foremost public health agency has been vacant since Jan. 31, when former Georgia public health commissioner Brenda Fitzgerald resigned after serving only half a year. She was unable to divest from “complex financial interests” in a “definitive time period,” according to an HHS statement. Fitzgerald had also purchased shares in a tobacco company shortly after becoming CDC director. Azar accepted her resignation two days after he was sworn in.
Azar was HHS general counsel under President George W. Bush and is among former Bush administration officials now at the department and in the White House who already were familiar with Redfield. The researcher was also a candidate for CDC director in 2002, but Julie Gerberding was chosen from within the ranks.
Redfield, whose current annual salary is $645,676, will be taking a significant pay cut to join the agency. The upper end of the basic salary range for director is about $190,000. Former director Tom Frieden earned about $207,000.
Colleagues say Redfield’s passions are his work and his faith. A devout Catholic, Redfield and his wife live in the Roland Park neighborhood of Baltimore, a few blocks from his church.
Alice Crites contributed to this article.