Obama names Colfax AIDS policy chief
by Seth Hemmelgarn
President Barack Obama has appointed Dr. Grant Colfax, the gay director of San Francisco's HIV Prevention Section, as the new director of the Office of National AIDS Policy, the White House announced Wednesday, March 14.
Referring to Colfax as "one of the nation's leading public health policy experts," administration officials said that he'll coordinate the continuing efforts of the government to reduce the number of HIV infections across the United States.
"Grant Colfax will lead my administration's continued progress in providing care and treatment to people living with HIV/AIDS. Grant's expertise will be key as we continue to face serious challenges and take bold steps to meet them. I look forward to his leadership in the months and years to come," Obama said in a statement.
Colfax wasn't available for comment Wednesday morning.
Eileen Shields, spokeswoman for the San Francisco Public Health Department, said that Tracey Packer, deputy director of the HIV Prevention Section, would take Colfax's place. She said that it would be up to Health Director Barbara Garcia to determine how long Packer serves in the position.
The national AIDS office coordinates with the National Security Council and the Office of the Global AIDS Coordinator, and works with international bodies to ensure that the U.S. response to the global pandemic is fully integrated with other prevention, care, and treatment efforts worldwide.
Through the President's Emergency Plan for AIDS Relief initiative, the U.S. "has made enormous progress in responding to the global HIV/AIDS pandemic, working with countries heavily impacted by HIV/AIDS to help expand access to treatment, care, and prevention," administration officials said.
Administration officials said that Colfax has focused on working with others "to implement sustainable, evidence-based HIV prevention and treatment interventions and policies in public health settings and measuring their effectiveness. Under his leadership, San Francisco greatly expanded HIV testing and treatment support efforts."
Colfax, who's HIV-negative, is a graduate of Harvard Medical School and completed his medical residency at UCSF.
People who work with some of San Francisco's best-known HIV and AIDS-based organizations praised Colfax's appointment.
Neil Giuliano, CEO of the San Francisco AIDS Foundation, said in a statement that Colfax "has been instrumental in the decline of new HIV infections in San Francisco in recent years."
He said Colfax's "unique blend of experience serving on the front lines of the epidemic, implementing the national strategy at the local level, working as a direct service provider within the Ryan White CARE system, and conducting cutting-edge research makes him the right person at the right time to lead the Obama administration's efforts to end HIV/AIDS in the United States."
Referring to implementation of the national Affordable Care Act, Ernest Hopkins, director of legislative affairs at SFAF, stated that he's confident Colfax "will work to ensure that the coming changes to our health care system are made thoughtfully, carefully, and with a strong focus on improving the health status of the most vulnerable people."
AIDS foundation staff also said that through instituting "innovative" prevention tools such as mapping community viral load, the city's HIV prevention planning and service system has become "a model for jurisdictions across the nation."
Dana Van Gorder, executive director of Project Inform, also praised Colfax's appointment.
"Grant is the ideal choice for this position at this moment," Van Gorder stated. "... Grant perfectly embodies the philosophy and skills needed to help the nation secure much needed gains over the epidemic."
Van Gorder also called Colfax "a leader of research establishing that providing a daily HIV medication, in combination with safe sex counseling, to gay and bisexual men at high risk of acquiring HIV infection can be up to 90 percent effective in helping them avoid infection." The approach is called Pre-Exposure Prophylaxis, or PrEP.
"The data on the effects of HIV treatment as prevention and PrEP make this a moment of incredible opportunity to stop HIV/AIDS," Van Gorder said.
Colfax replaces Jeff Crowley, who had served in that position since early in the Obama administration and left last November.
The White House statement didn't include what his salary will be.
Colfax's tenure as HIV Prevention Section director, which began in 2007, has seen some controversy. Much of that has involved the "greatly expanded HIV testing and treatment support efforts" that the Obama administration mentioned in its statement.
With San Francisco's HIV rates stalled at endemic levels, meaning new infections have remained steady for the last 11 years, Colfax has argued the city's model of HIV care it has relied on since the beginning days of the AIDS crisis 30 years ago is no longer viable.
"Unless we change what we do, we are not going to eliminate new infections because we are in an endemic," Colfax has said.
He recently ushered in a new direction for how the city, and the community-based agencies it funds, approach reducing the spread of HIV.
A higher focus is being given to testing people regularly and offering treatment sooner to people who are HIV-positive in an attempt to further reduce new infections in San Francisco. More attention is also being paid to the overall HIV viral load in the community, as new research has shown reducing viral load counts helps bring down new HIV infections.
Health education and risk reduction has been de-emphasized.
Some in the community bristled at the changes.
Jonathan Batiste, a former member of the city's HIV Prevention Planning Council, said the adjustments were "very divisive."
Colfax "acted as if he did not understand what issues we had with his 'new directions.' ... I always called them 'Grant's directions,'" Batiste said. He said he left the council because of his frustrations.
But Michaela Hoffman, HIV services director at Mission Neighborhood Health Center, which offers testing and other services, said Colfax's departure would be a loss for San Francisco.
Hoffman, who started in her position after much of the "new directions" turmoil, said that her agency has been reminding Colfax's office that when it comes to HIV prevention, there are diverse needs and "one size doesn't fit all."
She said Colfax and other officials "are going to great lengths to hear from providers," and she has "no complaints" about outreach.