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Kristine Gebbie, first White House AIDS czar, dies at 78

Kristine Gebbie is introduced as the White House coordinator of AIDS policy by President Bill Clinton in 1993. (Greg Gibson/AP)

Kristine Gebbie, who was named by President Bill Clinton as the country’s first coordinator of AIDS policy in 1993, then left the post after a year, saying the job was poorly defined and had little real authority, died May 17 at a hospital in Adelaide, Australia. She was 78.

The cause was cancer, said her daughter Eileen Gebbie. Dr. Gebbie had been living in retirement in Australia.

With a background in nursing and education, Dr. Gebbie was the top public health official in the states of Oregon and Washington before joining the Clinton administration as coordinator of the Office of National AIDS Policy. She was often described as the country’s “AIDS czar.”

Acquired immunodeficiency syndrome, or AIDS, had claimed the lives of about 200,000 Americans at the time and was the leading cause of death of people ages 25 to 44. It was particularly widespread among gay men.

Dr. Gebbie had previously served on a presidential AIDS commission during the administration of Ronald Reagan and led a national AIDS task force of state health officials. But she said neither Reagan nor his Republican successor, George H.W. Bush, had taken the disease seriously as a public health crisis.

“I would never have been here in the Bush or Reagan administration,” she said in 1993. “They weren’t interested in AIDS.”

After her appointment, Dr. Gebbie’s supporters and detractors both agreed that her mission was poorly delineated by the White House, giving her little chance of leading a breakthrough in the fight against AIDS. She had a staff of only 30, and her office was not next to the White House in the Executive Office Building but across 17th Street NW, 10 floors above a McDonald’s franchise.

Despite being called the AIDS czar, Dr. Gebbie had little control of the federal government’s AIDS response, with little influence over the direction of research and spending. Her primary responsibility was to coordinate research and messaging among several federal agencies, including the U.S. Public Health Service, the Centers for Disease Control and Prevention, and the National Institutes of Health.

During that time, Larry Kramer and other AIDS activists were leading confrontational demonstrations at NIH and around the country. They disrupted national newscasts and once covered the house of Republican Sen. Jesse Helms (N.C.) with a giant condom.

Larry Kramer, writer who sounded alarm on AIDS, dies at 84

“To the very active AIDS advocacy groups, particularly those on the East Coast, I’m an uninfected, straight White woman from the Northwest,” Dr. Gebbie said. “How could I possibly be their hero in this epidemic?”

Dr. Gebbie recognized that AIDS was not just a medical problem but that it posed a variety of social challenges, as well.

“It leads you into just about every complicated human question that you have to deal with,” she told the Los Angeles Times after joining the Clinton administration. “What does human sexuality mean? What is the balance point between an individual’s rights and responsibilities and a community’s rights and responsibilities? What is our responsibility to people at the end of life?”

Nevertheless, she helped institute mandatory training programs on HIV/AIDS for all federal employees and advocated for more research funding. She also oversaw the development of the first federally funded public service advertisements that mentioned condoms and urged Americans to “talk much more openly about sexual activity.”

“I might choose for all children to stay abstinent from sex till they’re 23 years old and married, but I know that choice is not real,” she told the Oregonian newspaper in 1994. “And therefore I think we’re obliged to give kids information about condoms and safer sex practices. We’re obliged to give them the information that can help them live.”

After 13 months, Dr. Gebbie resigned under pressure. Critics said she was overwhelmed by the job, partly because she had too little guidance from the White House and was unable to build support on Capitol Hill. (The Office of National AIDS Policy was discontinued under President Donald Trump but was revived last year by President Biden.)

“This was a new job with almost nothing written down about what it should be, and expectations were too high,” she said in 1994. “Some people will never be happy about this position unless it is the job of a real czar who can command viruses, money and jobs.”

Kristine Elizabeth Moore was born June 26, 1943, in Sioux City, Iowa. Her father was an Army officer, and her mother was an administrator with the U.S. Fish and Wildlife Service. She spent part of her childhood overseas and in Montana and New Mexico.

She received a nursing degree in 1965 from St. Olaf College in Northfield, Minn., and a master’s degree in nursing from the University of California at Los Angeles in 1968. Early in her career, she was a hospital administrator and taught nursing at UCLA and St. Louis University. She helped develop nursing standards that were adopted nationwide. She received a doctorate in public health from the University of Michigan in 1995.

Dr. Gebbie was Oregon’s top-ranking public health official from 1978 to 1989 and then led the state of Washington’s health department until 1993. After her year as AIDS coordinator in Washington, Dr. Gebbie became a nursing professor at Columbia University and directed the school’s Center for Health Policy from 1994 to 2008. She later served two years as dean of the Hunter-Bellevue School of Nursing at New York’s Hunter College before retiring to Australia, where she was an adjunct professor at several colleges.

Her marriage to Neil Gebbie ended in divorce. Her husband of 27 years, Lester Wright, died in April. Survivors include three children from her first marriage, Anna Gebbie of Binghamton, N.Y., Eileen Gebbie of Urbana, Ill., and Eric Gebbie of Portland, Ore.; two stepsons, Jason Wright of Portland and Nathan Wright of Tacoma, Wash.; a sister; 10 grandchildren; and a great-granddaughter.