The Atlanta-based U.S. Centers for Disease Control and Prevention has been without a permanent director since Dr. Brenda Fitzgerald resigned in January. News reports suggest the Georgian’s replacement may be a very different type of health expert.
Dr. Robert Redfield, an AIDS treatment pioneer who has gained expertise in treating heroin addiction, has been reported on national news sites as the leading candidate by anonymous administration officials.
The news drew strong reaction this week in interviews with The Atlanta Journal-Constitution from both his supporters and detractors — from experts and advocates who have seen his recent decades of clinical work to colleagues and opponents from his early years who raised concerns about his ethics and approach.
“You never know until people take over the reins of a big institution like this,” said Dr. Thomas Quinn, a professor at the Johns Hopkins Bloomberg School of Public Health. “But I actually think he has the leadership skills. He certainly has the medical background. … It’s a leadership position where he hopefully will defend the centers, their budget, their agenda. He’ll get engaged with areas he knows best, which will be infectious diseases, and drug and substance abuse. And those are the two things I worry most about.”
Redfield is described as an avid clinician who has developed treatment programs for AIDS patients both in Maryland and internationally, overseeing care of hundreds of thousands of patients and looking for better treatments. He co-founded in 1996 the Institute of Human Virology, which describes itself as the first center in the United States to combine the disciplines of basic science, epidemiology and clinical research, in order to speed discovery of new ways of treating chronic and deadly viral and immune disorders.
He is also known as a Catholic and a conservative, and someone able to navigate the political world.
“He is along sort of the Republican conservative ideology. But he’ll still put medicine first,” Quinn said. “Because the Republicans are in the majority, I think he’s going to be able to relate very well to their leadership.”
Is the past past?
Redfield’s personal bent is at the root of one issue that dogs him. In the early years of the AIDS epidemic, he took deeply conservative positions on issues such as mandatory screening and patient segregation. Patient advocates said those positions were contrary to science, would add to the enormous stigma of AIDS, and cause the infected to flee underground and the epidemic to get worse.
“The science was known at the time,” said Jeffrey Levi, who battled with Redfield at the time. Levi is a professor of health management and policy at George Washington University’s Milken Institute School of Public Health.
Asked whether Redfield was a good pick for CDC director, Levi said, “The short answer is no.”
That is one of two lines of controversy in Redfield’s past. The other was a serious battle over his scientific conduct when Redfield served in the military and for a time seemed on the path of a vaccine to prevent AIDS. Such a discovery would have been earth-shaking in the scientific community.
In 1992, two fellow military researchers wrote a scathing letter accusing Redfield of continually claiming his results were better than they were, despite being warned and agreeing to stop.
They weren’t offhand comments, but prominent statements including an article in the prestigious New England Journal of Medicine and a presentation at a conference in Amsterdam. Dr. Craig Hendrix and Dr. Neal Boswell called for an independent outside investigation.
Hendrix is now also a professor at Johns Hopkins focusing on drugs for AIDS. Boswell for years worked at a clinic for the poor in Brunswick, and he has been honored by the Georgia Hospital Association. Boswell did not respond to a message from the AJC forwarded to him by the clinic.
The doctors and supporting witness statements alleged a number of offenses, including that Redfield cherry-picked his results, bullied a statistician to analyze his data in a way the statistician thought was not right, and continued to overstate his results.
“We regret that the problem must be raised to this level, but actions taken to date have failed to resolve the problem. The scientific credibility of the entire (Military Medical Consortium for the Advancement of Retroviral Research) is at risk and is already being questioned by those outside our organization. …We cannot continue to deceive.” Hendrix told the AJC this week that he stands by the letter.
An initial institutional review subcommittee found that Redfield’s representations “seriously threaten his credibility as a researcher” and “creates false hope and could result in premature deployment of the vaccine.” In the end, what the AJC reported at the time as “an informal review” found the actions did not rise to the level of misconduct.
Dr. Sidney Wolfe, a consumer advocate at Public Citizen who in 1994 obtained the documents, said this week that Redfield’s name “should be immediately withdrawn.”
A caring, daring clinician
Rearchers and advocates who have worked with Redfield in the years since point to two decades of different work; good and important work. His supporters point to his work helping a patient population full of gay men and others under threat of stigma.
“The criticism that’s been brought up was 25 years ago or more,” said Dr. James Curran, an epidemiology professor and dean of the Rollins School of Public Health at Emory University. “What I look at in these kinds of circumstances was not only what was going on then but what’s happened since. What you see in Dr. Redfield is someone committed to the field. There’s a lot of people who’ve been controversial and moved on to something else. … He’s somebody who’s really walked the walk.”
No less a Democrat than Kathleen Kennedy Townsend vouches for him, too. She has known Redfield for two decades as a member of his institute’s board. In such positions, it’s the director’s job to tell board members things that are going wrong before they become public embarrassments.
She called him “a person who changes as life circumstances change.”
“I’m impressed by his integrity, his forthrightness and his caring,” she said. “And his deep devotion to his patients.”