No sooner was Health and Human Services (HHS) honcho Tommy Thompson back from the International AIDS Conference in Barcelona, where his speech was booed down by activists (see "Worlds Collide"), than the Bush administration signaled a major change-up in White House AIDS personnel. Out was AIDS czar Scott Evertz, a leading gay Republican from Thompson's home state of Wisconsin, replaced by gay AIDS doctor and civil servant Joseph O'Neill. Out, too, was the director of the Presidential Advisory Council on HIV/AIDS, abstinence-only advocate Patricia Ware. Between the bungled speech and the shuffled staff, the administration appeared to be, if not in AIDS chaos, at least projecting "more confusion than coherence," according to GMHC associate director Ronald Johnson. The media consensus was that, in the moderate/conservative tug-of-war that drives Bush policymaking, neither camp had scored a clear victory.
A Who's Who of the religious right had opposed Evertz's appointment 15 months earlier. Focus on the Family issued an "action alert" that a gay man in the nation's AIDS bully pulpit indicated Bush's support for "promiscuous sexual behavior, rampant among homosexuals"; Concerned Women for America warned that his "homosexual activism will hurt support for the GOP among the party's core base of religious-minded voters." The former Log Cabin leader and fundraiser for anti-abortion causes sparked further controversy when, as AIDS czar, he blurted opinions at odds with the right's, announcing on TV that "science, not politics" would decide Bush AIDS policies. During a nationwide "listening tour" of community organizations, he won the grudging respect of advocates for his support for needle exchange as well as for Stop AIDS Project's pro-sex prevention campaigns for San Francisco gay men, currently the target of a federal investigation for allegedly violating "community standards" (see "New Head, Same Hydra?" ).
But just as removing this lightning rod was a bone thrown to the right, replacing Evertz with another gay man comforted nervous moderates, as did the decision to keep Evertz on as assistant to Thompson on global AIDS. And announcing the simultaneous removal of Ware, lovingly described by the far-right powerhouse Family Research Council as "an unabashed advocate of pro-family concerns," seemed to even the score.
But the theory that Bush was playing to the center soon fell apart. Several AIDS Beltway insiders described strong tensions between Evertz, backed by the moderate Thompson (whose gubernatorial campaigns Evertz worked on), and Ware, backed by right-wing HHS deputy secretary Claude Allen, a former Jesse Helms staffer who supports abstinence-only. Less than a week after the Ware leak, word came that she would stay on -- and suddenly it looked like her camp had won.
In retrospect, Ware's announced departure was likely a trial balloon. When the far right responded unanimously, lobbying for Ware both publicly and behind the scenes, team Bush pulled back.
While Evertz said in an official statement that he was "thrilled" about his new post (he and O'Neill were both muzzled from interviews), and White House flaks insisted that Evertz was still "integral to the administration's AIDS policies," advocates told POZ that Bush family friend Bill Steiger, Thompson's special assistant for international affairs, already manages the administration's global AIDS efforts, making Evertz, in effect, the special assistant to a special assistant. That the ledger had tilted away from "science" and toward "politics" became even clearer as the religious right ponied up faint praise for openly gay AIDS czar No. 2. "Scott didn't know if he wanted to be Bush's advocate in the gay community or the gay community's advocate in the Bush administration," Concerned Women rep Michael Schwartz said. "O'Neill's an improvement. It will be harder for the press to push him to say injudicious things."
Some political operatives suspect that the lurch rightward was carefully timed. "If fundamentalist Christians were the ones who saved Pat Ware's job, that's an obvious indicator of who the administration is looking to for guidance," said Chad Johnson, ED of National Stonewall Democrats. "I hope this is not a grand conspiracy to placate the Republican base. But it looks like pure politics to me." There is other evidence to justify the conspiratorial view. Last March, White House political strategist Karl Rove addressed the Family Research Council's annual Washington Briefing, assuring religious-right activists that the administration backed their agenda of funneling federal money to churches, restricting abortion, opposing gay rights and promoting marriage -- all positions that Allen and Ware promote.
Despite these political winds, HIVers may find an ally in the new czar. POZ spoke with several AIDS docs and advocates who have worked closely with O'Neill, all of whom said that his years in the federal bureaucracy will indeed make him more circumspect than Evertz, but also, potentially, more effective. "He's been able to weather the Republican storm and move through the ranks," said Lynda Dee, ED of AIDS Action in Baltimore, where O'Neill once worked as an AIDS doc. "He knows where the bodies are buried and how to get things done." During his five years at the Health Resources and Services Administration, where he was in charge of the entire Ryan White program, he actively encouraged community involvement, the advocates said. And he's a bona fide HIV practitioner who understands the medical issues intimately and has clinical experience with the gay community, substance users and people of color, according to David Shippee, who supervised O'Neill in the early '90s at Baltimore's Chase Braxton clinic. Treatment Action Goup's Mark Harrington, who sat with O'Neill on the federal panel that drafted HAART guidelines in 1997, said the new czar is "someone we can do business with."
Though O'Neill has yet to weigh in publicly on hot-button issues from needle exchange to sexually frank prevention, those who know him well said he has always been guided by a grounded understanding of AIDS. Dee recalled that when O'Neill was charged with conducting an audit of UNAIDS, he hired the person who had designed Dee's agency's HIV prevention plan -- an outspoken advocate of explicit approaches -- to do the job.
Just as the dust settled from the AIDS reshuffle, more worrisome noises emerged from the GOP: Twelve Republican members of Congress sent a letter to Thompson to protest his "rude reception" at Barcelona and the "religion-bashing" tenor of the conference -- and to launch an investigation into whether any AIDS organizations used federal funds to attend. One of these pols, Rep. David Souder of Indiana, was behind the unprecedented audit of HIV programs now underway at the CDC, which has created "a culture of tension and micromanagement," according to a Fox News report. "If the goal of the audit is to put the community on notice that we need to be fiscally responsible, OK," said Daniel Montoya, director of government affairs for AIDS Project Los Angeles. "But if the audit focuses on programs from an ideological rather than an epidemiological perspective, the community would be anxious."
Another source of anxiety? The revelation in the July 19 Science that Thompson's staff forced officials at Barcelona to remove a strongly pro-condom Thai senator scheduled to share the stage.