Editor’s Note: Laurie Garrett is a former senior fellow for global health at the Council on Foreign Relations and a Pulitzer Prize-winning writer. The opinions expressed in this commentary are hers.
The US Centers for Disease Control and Prevention has a new boss, Dr. Robert Redfield, who ignited controversy because of his dubious qualifications for the job and the over-the-top salary offer that came with it. Initially slated to earn $375,000 a year, Redfield faced questions from Democrats, led by Sen. Patty Murray of Washington, and last week agreed to work for $209,700 instead.
“Dr. Redfield did not want his compensation to become a distraction from the important work of the CDC and asked that his salary be reduced,” Caitlin Oakley, spokesperson for the Department of Health and Human Services, said Tuesday night.
Redfield’s original salary was unusually, astoundingly high. Redfield’s boss, Health and Human Services Secretary Alex Azar makes only $175,300, and most scientists and physicians working in HHS make less than $170,000 a year.
I scrutinized nearly 1,000 pages of payroll listings at the Department of Health and Human Services, and found few CDC employees who earn more than $150,000 annually. Some make considerably more than that, thanks to Title 42, a policy that gives federal agencies flexibility on salary limits in order to lure outstanding scientists and other professionals into government work.
Nearly all of those scientists are classified as Medical Specialists, 138 of whom earn more than $250,000. All but 13 work at the National Institutes of Health, engaging in basic scientific research.
Just two individuals make more than $350,000, ranking them the most highly paid federal employees after the President (who is paid $400,000): Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, and Rachel Sherman, deputy commissioner of the Food and Drug Administration. Having run NIAID since 1984, Fauci is the longest serving Institute director in NIH history. He has been an adviser to five presidents, architect of the HIV program PEPFAR, the 24th most-cited scientist in history and recipient of every major biomedical award besides the Nobel Prize, including the Presidential Medal of Freedom and the National Medal of Science.
Sherman tried to resign her FDA post in 2014, but the Obama administration fought to retain her, as she has proven invaluable in designing and overseeing virtually every pharmaceutical testing, labeling and surveillance program used by the agency.
To put this into further perspective, Dr. Francis Collins, director of the National Institutes of Health, makes $199,700. The Food and Drug Administration’s leader, Scott Gottlieb, takes in $155,500.
Was Robert Redfield worthy of the original $375,000 annual income, or the still-well-above-average government income of $209,700, in the role of director of the nation’s primary public health institution?
His salary offer was legally permitted under Title 42 – meant to help attract top-flight scientists who might not otherwise be interested in the job. But this was not the case with the University of Maryland researcher: Redfield actively sought the CDC leadership position, and was vetted by the George W. Bush administration–though rejected for the post.
Still, he took a considerable pay cut, because his pay last year during a 15-month period at the University of Maryland topped $827,000, with his base salary of $650,000 plus bonuses and consulting fees, according to The Wall Street Journal.
That was for Redfield’s work at the Institute of Human Virology, a $105 million HIV/AIDS program led by Robert Gallo, a former NIH researcher. Redfield managed the institute’s clinical-care program for people with HIV.
Redfield’s early engagement with the AIDS epidemic in the US in the 1980s and 90s was controversial. As an Army major at Walter Reed Medical Institute, he designed policies for controlling the disease within the US military that involved placing infected personnel in quarantine and investigating their pasts to identify and track possible sexual partners. Soldiers were routinely discharged and left to die of AIDS, humiliated and jobless, often abandoned by their families.
In the 1980s Redfield worked closely with W. Shepherd Smith, Jr. and his Christian organization, Americans for a Sound AIDS/HIV Policy, or ASAP. The group maintained that AIDS was “God’s judgment” against homosexuals, spread in an America weakened by single-parent households and loss of family values.
Redfield wrote the introduction to a 1990 book, “Christians in the Age of AIDS,” co-written by Smith, in which he denounced distribution of sterile needles to drug users and condoms to sexually active adults, and described anti-discrimination programs as the efforts of “false prophets.”
In the early 1990’s, ASAP and Redfield also backed H.R. 2788, a House bill sponsored by deeply conservative Rep. William Dannemeyer (R-California). It would have subjected people with HIV to testing, loss of professional licenses and would have effectively quarantined them. (The bill died in Congress.) In the 2000s, Redfield was a top advocate for the so-called “ABCs of AIDS” in Africa, pressing to prevent HIV infection through sexual abstinence, monogamy and the use of condoms only as a last resort.
In 1992, Redfield, then a colonel, was part of a Walter Reed team backing an AIDS vaccine called VaxSyn, manufactured by a Connecticut company, MicroGeneSys. Redfield claimed that a small clinical trial had shown VaxSyn to protect the immune systems of infected soldiers, limiting the worst outcomes of AIDS.
Because this was a clear exaggeration, the Army investigated Redfield, eventually concluding he had made an innocent mistake. Redfield continued to strongly support VaxSyn, pushing Congress to fund a $20 million clinical trial on HIV-positive men. But VaxSyn never worked, and no fine-tuning in its biochemistry could have made a difference.
Independent scientists showed that the MicroGeneSys compound targeted a part of the HIV virus that mutates so frequently that infected individuals’ bodies are filled with multiple forms, most of which VaxSyn could not affect.
The White House has had a hard time choosing, vetting and retaining top appointees. After 16 months in office the President has fired or accepted the resignations of 23 top officials, including Redfield’s predecessors, Dr. Thomas Frieden and Dr. Brenda Fitzgerald. Frieden, who served as health commissioner for New York City and was appointed by President Barack Obama, made $219,700 in the position.
Six months later, Dr. Fitzgerald, then state health commissioner in Georgia, was appointed to lead the agency that protects Americans from epidemics, water contamination, cancer-causing compounds and hundreds of other health threats, at a salary of $197,000. Questions were immediately raised about her relationship with the Coca-Cola Corporation and their sponsorship, at her behest, of a Georgia anti-obesity campaign.
In September Fitzgerald made decisions in CDC’s Atlanta headquarters involving $28.6 million worth of private contracts for electronic data-keeping relevant to opioid prescriptions. One of the companies receiving those grants was Greenway Health, in which Fitzgerald and her husband held stock worth $300,000. Senate queries led to a larger investigation and the discovery that she continued in December to hold stocks in pharmaceutical and medical management companies that posed clear conflict violations.
And on Jan. 30 she submitted her resignation, following a Politico disclosure that the Fitzgeralds owned tens of thousands of dollars’ worth of tobacco stocks, some of which had been purchased after her CDC appointment.
Burned by the Fitzgerald mess, presumably the White House carefully vetted Redfield, a former Army colonel and a University of Maryland HIV clinician and virologist, before announcing his appointment in April.
It is very hard to understand what accomplishments prompted the University of Maryland to consider Redfield worth $827,000 for 15 months. But it is not hard to see why President Trump would see Redfield’s hardcore, right-wing credentials as a good fit. Giving this doctor such a prominent job at such ridiculous pay – even a lowered sum – is another example of the Trump administration’s willingness to place politics over sensible public policy.