Messages from Byzantium

The NYT describes how the man in charge of fighting AIDs was fired in unknown circumstances and how his replacement is being named in an even less transparent manner.

On Jan. 9, Dr. Dybul circulated a memo saying he had been asked by President Obama’s transition team to stay on the job temporarily. But on Jan. 22, one day after Hillary Clinton was confirmed as secretary of state, her staff announced that Dr. Dybul had resigned.

No reason was given, but he was reported to have packed up his office and said an emotional goodbye to his staff that afternoon. Dr. Dybul did not return phone messages, but he has told friends that he does not even know on whose orders he was dismissed.

The question of who should run the program seems to be a legacy of that fight. Several names have been discussed as possible candidates, but AIDS activists say they know of no one who has been seriously vetted for the job by the Obama transition team since November. …

A day after Dr. Dybul’s resignation, word began to circulate among AIDS activists that the job had been offered to Dr. Eric Goosby, the director of AIDS policy in Bill Clinton’s administration, who now runs a San Francisco foundation devoted to fighting AIDS.

According to a member of an anti-AIDS group speaking on the condition of anonymity, Senator John Kerry approached Mrs. Clinton, seeking the job for Dr. Jim Yong Kim, a Harvard medical school professor and former World Health Organization AIDS chief, and was told that she had offered it to Dr. Goosby. …

Both men had been discussed as possible candidates, along with Dr. Nils Daulaire, president of the Global Health Council; Dr. Wafaa El-Sadr, an epidemiologist at the Columbia School of Public Health; and Warren W. Buckingham III, Pepfar’s director in Kenya, who is openly gay and taking AIDS drugs himself. …

The abruptness of Dr. Dybul’s departure and the secrecy of the process to replace him has upset some AIDS policy specialists.

I have no idea who the best man for the job is, but if the appointments process resembles that described by the New York Times it suggests that the appointments process in certain parts of Washington hinges not on what you know, but who you know, or worse, what politics, lifestyle or symbolism you embrace. And this is a medical job. It’s a helluva way to run a railroad. And if the NYT is exercised about it, then it really must be jaw dropping.