Robert R. Redfield

Redfield's medical residency was at Walter Reed Army Medical Center (WRAMC) in Washington, D.C., where he completed his postgraduate medical training and internships in internal medicine (1978-1980), as a U.S. Army officer. Redfield completed clinical and research fellowships at WRAMC, in infectious diseases and tropical medicine, by 1982.[3]

Redfield continued as a U.S. Army physician and medical researcher at the WRAMC for the next decade, working in virology, immunology and clinical research. He collaborated with teams at the forefront of AIDS research, publishing several papers and advocating for strategies to translate knowledge gained from clinical studies to the practical treatment of patients afflicted by chronic viral diseases.[3]

Redfield retired from the Army in 1996 as a colonel.[6]

In 1996, Redfield, his HIV research colleague Robert Gallo and viral epidemiologist William Blattner co-founded the Institute of Human Virology at the University of Maryland School of Medicine. It is a multidisciplinary research organization dedicated to developing research and treatment programs for chronic human viral infection and disease.[2]

At the University of Maryland School of Medicine, Redfield served as a tenured professor of medicine and microbiology, chief of infectious disease, and vice chair of medicine.[2] Redfield is known for his contributions in this period — in clinical research, in particular, for research into the virology and therapeutic treatments of HIV infection and AIDS. In the early years of investigations into the AIDS pandemic in the 1980s, Redfield led research that demonstrated that the HIV retrovirus could be heterosexually transmitted.[2][3][7][8] He also developed the staging system now in use worldwide for the clinical assessment of HIV infection.[2][3] Under his clinical leadership at the University of Maryland the patient base grew from 200 patients to approximately 6,000 in Baltimore and Washington, D.C., and more than 1.3 million in African and Caribbean nations.[9] His clinical research team won over $600 million in research funding.[10] While holding this position, he was interviewed for the controversial HIV/AIDS film, "House of Numbers".[11]

Redfield served as a member of the President's Advisory Council on HIV/AIDS from 2005 to 2009, and was appointed as chair of the International Subcommittee from 2006 to 2009. He is a past member of the Office of AIDS Research Advisory Council at the National Institutes of Health, the Fogarty International Center Advisory Board at the National Institutes of Health, and the Advisory Anti-Infective Agent Committee of the Food and Drug Administration.

Redfield speaks on the COVID-19 pandemic in January 2020

Redfield became the director of the Centers for Disease Control and Prevention on March 26, 2018.[12] He was appointed to the post by President Donald Trump, after the president's first appointee resigned in scandal.[13] His appointment was considered controversial; he was publicly opposed by the Center for Science in the Public Interest and Patty Murray, the ranking Democrat on the Senate health committee, but supported by Kathleen Kennedy Townsend and some advocates for AIDS patients.[14][15][16][17] In his inaugural address to the CDC, Redfield called the agency "science-based and data-driven, and that's why CDC has the credibility around the world that it has".[12]

The first confirmed case of COVID-19 was discovered in the U.S. on January 20, 2020,[18] while Redfield was serving as director of the CDC. Redfield has been a member of the White House Coronavirus Task Force from its start on January 29, 2020.[19]

On February 13, 2020, Redfield said that the "virus is probably with us beyond this season, beyond this year, and I think eventually the virus will find a foothold and we will get community-based transmission".[20] This contrasted with statements by Trump, who told the public through most of February that the virus was under control.[21]

During February 2020, the CDC's early coronavirus test malfunctioned nationwide. Redfield reassured his fellow task force officials that the problem would be quickly solved, according to White House officials.[22] It took about three weeks to sort out the failed test kits, which may have been contaminated during their processing in a CDC lab. Widespread COVID-19 testing in the United States was effectively stalled until February 28, when the faulty test was revised, and the days afterward, when the Food and Drug Administration began loosening rules that had restricted other labs from developing tests.[23] Later investigations by the Food and Drug Administration and the Department of Health and Human Services found that the CDC had violated its own protocols in developing the faulty test.[22][24]

Redfield testified to Congress on March 2, 2020, about the outbreak of COVID-19 in the U.S. Given the lack of testing on patients and healthcare workers requesting testing, Florida Democrat Debbie Wasserman Schultz asked Redfield about who was responsible to ensure testing could be performed on individuals who needed to be tested. Redfield could not name a specific individual and looked to Dr. Anthony Fauci, director of infectious disease at the NIH, who said, "The system is not geared to what we need right now... that is a failing."[25][26]

On July 14, 2020, Redfield warned that the winter of 2020–2021 would probably be "one of the most difficult times that we've experienced in American public health".[27] He also said, "If we could get everybody to wear a mask right now, I really do think over the next four, six, eight weeks, we could bring this epidemic under control."[28] Trump, asked about Redfield's statements, said he opposed a mask law and said "masks cause problems too," but also said, "I think masks are good".[29]

On July 23, the CDC called for reopening American schools, in a statement written by a working group at the White House that included Redfield but had minimal representation from other CDC officials.[30]

Trump publicly contradicted Redfield on September 16, 2020, on the timeline for a COVID-19 vaccine and the effectiveness of masks compared with inoculation. Redfield told a Senate panel that a limited supply of a COVID-19 vaccine might be available in November or December, but that the general public would not be inoculated until the summer or fall of 2021.[31] Redfield also said that masks could be a more effective protection against COVID-19 than the vaccine. After Redfield's testimony, Trump told reporters, "I believe he was confused" and said a vaccine could be available in weeks and go "immediately" to the general public.[32][33]

In September 2020, Redfield sought to extend a no-sail order on passenger cruise ships into 2021 to prevent the spread of COVID-19, but he was overruled by Vice President Mike Pence. The no-sail order was instead set to expire on October 31, 2020. Some of the severest early outbreaks of COVID-19 were on cruise ships.[34]

The CDC's actions during the pandemic have led to intense scrutiny of Redfield in congressional hearings and in media reports.[35]

Laurie Garrett, a science journalist who is a former senior fellow for global health at the Council on Foreign Relations, called Redfield "about the worst person you could think of to be heading the CDC at this time" and said "he lets his prejudices interfere with the science, which you cannot afford during a pandemic".[36] William Schaffner, an infectious-disease specialist at Vanderbilt University, said "Bob Redfield’s commitment to public health is completely strong," but said that Redfield has had trouble advocating effectively inside the White House.[37] Trump is said to like Redfield but distrusts the CDC.[37]

Redfield has been the Trump administration's point man for delivering public health warnings on conservative talk radio.[38]

On April 9, 1988, the American Foundation for AIDS Research (AmFAR) sponsored a "Scientific Forum on the Etiology of AIDS". One of the presenters, William Haseltine showed a slide called "AIDS Virus and Antibody" purporting to reflect the serology model of AIDS. Two of the audience members, both professors of Molecular and Cellular Biology at the University of California Berkeley asked why Haseltine's graph had no units on it on the y axis and gibberish on the x-axis. Haseltine remarked the graph had been created by Redfield, who muttered, "different measures were used". Later at a post-conference party, Redfield admitted he had made the slide up - it was not based on any data at all.[41] Haseltine later published two additional fake graphs by Redfield in the Journal of the American Medical Association.[42][43][44]

In 1992, the Defense Department investigated Redfield after he was accused of misrepresenting the effects of an experimental HIV vaccine, the study of which he had overseen.[45][46][47] On the basis of this data, in 1992, the U.S. Senate gave a $20 million appropriation for a private company, MicroGeneSys, to develop a therapeutic HIV vaccine based on the protein gp160, which went into clinical trials. Randy Shilts, author of And The Band Played On, wrote that the idea of a therapeutic vaccine was a radical idea that came to Redfield while reading his children a book about Louis Pasteur which he then discussed with Jonas Salk who was in support.[48] At the time a U.S. Army Lieutenant Colonel, Redfield was the Army's leading AIDS researcher, and a proponent of the vaccine.

In July 1992, Redfield gave an abstract presentation on the vaccine at the international AIDS conference in Amsterdam. Based on preliminary results of 15 of the 26 patients who got the vaccine, Redfield said that the viral load of patients getting the vaccine was lower than patients who did not get the vaccine. Most researchers believe that viral load is a good indicator of vaccine effectiveness. The vaccine later turned out to be ineffective. Many researchers, however, were skeptical of the data, and were unable to reproduce Redfield's analysis.[46][49] Craig Hendrix, a US Air Force scientist (now at Johns Hopkins) said that Redfield committed scientific misconduct by misusing data in studies of the vaccine.[50]

In 1993, a U.S. Army investigation acknowledged accuracy issues with the HIV vaccine clinical trials,[49] but concluded that their investigations "did not support the allegations of scientific misconduct,”[51][45] and he was subsequently promoted to colonel. Redfield is quoted in Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine, the comprehensive book on the controversy, as saying of his accusers, "I am disappointed in the institutions for not holding the individuals accountable for what I consider conduct unbecoming of an officer."[6]

Redfield continued studies of the gp160 vaccine; the results of the 27-author phase II clinical trial were published in the Journal of Infectious Disease in 2000, concluding that the vaccine was ineffective, with Deborah L. Birx as lead author.[52] Redfield's multi-site study was a collaboration between the Department of Defense and the National Institutes of Health,[52] The work did not, however, result in an effective vaccine.[45]

The 1993 investigation said that Redfield had an "inappropriate" close relationship with the non-governmental group "Americans for a Sound AIDS/HIV Policy" (ASAP), which promoted the gp160 vaccine. The group was founded by evangelical Christians who worked to contain the HIV/AIDS outbreak by advocating for abstinence before marriage, rather than passing out condoms — a view Redfield says he's since changed.[51][53]

Redfield served on the board of ASAP, which gay groups criticized for anti-gay, conservative Christian policies, such as abstinence-only prevention.[54] Redfield also authored the foreword to the book co-written by ASAP leader W. Shepard Smith, "Christians in the Age of AIDS", which discouraged the distribution of sterile needles to drug users as well as condom use, calling them "false prophets". The book described AIDS as "God's judgment" against homosexuals.[55] At the time of his nomination to head the Centers for Disease Control and Prevention, Redfield maintained close ties with homophobic activists,[54] although he has publicly supported the use of condoms and denied ever promoting abstinence-only interventions.[12] However, in the 2000s, Redfield was a prominent advocate for the ABCs of AIDS doctrine, which promoted abstinence primarily and condoms only a last resort.[56]

In 2018, after Redfield was appointed to the CDC, Democrats and watchdog groups criticized his $375,000-a-year salary, which was significantly higher than the $219,700 salary of his predecessor, Tom Frieden, and higher than that of Redfield's boss, Alex Azar, the Secretary of Health and Human Services. Azar (a former president of a division of Eli Lilly) and the head of the FDA had taken significant pay cuts on moving into government service, but their salaries are set by Congress while the salary of the CDC director is not.[57] Within a few days, Redfield asked for and received a pay reduction to $209,700 from $375,000 because "[he] did not want his compensation to become a distraction from the important work of the CDC".[58]

On 6 April 2020, to justify his belief that social distancing could be effective and that coronavirus deaths would not be as high as models predicted, Redfield stated on AM 1030 KVOI Radio in Tucson, Arizona, "those models that were done, they assume only about 50 percent of the American public would pay attention to the recommendations".[59][60][61]

On 22 September 2020, Rachel Maddow reported on MSNBC that Redfield had allowed significant tampering of CDC COVID-19 recommendations to a meat packing company by the Trump administration.[62]