A Thank You and Tribute to Ambassador Eric Goosby

Ambassador Goosby and Dr. Fauci at the Fifth Annual International AIDS Society Conference on Pathogenesis, Treatment and Prevention in Cape Town, South Africa. © International AIDS Society / Simon Deiner / SDR PhotoOn November 1, 2013 Ambassador Eric Goosby wrapped up his extraordinary tenure as United States Global AIDS Coordinator and head of the U.S. Department of State’s Office of Global Health Diplomacy, and returned to his home town of San Francisco. For more than four years, Eric led all U.S. government international HIV/AIDS efforts with great skill, vision and dedication. Let me share a few thoughts about Eric, who has been a close friend, confidante and colleague for 3 decades.

Many people came to know Eric as head of the President’s Emergency Plan for AIDS Relief (PEPFAR); however, they may not be fully aware of his background – and why he was so inherently suited to his role as Global AIDS Coordinator. The story starts with Eric’s upbringing in San Francisco. His passion for public service came from his parents and his inherently empathetic nature, and was fortified by his Jesuit education at St. Ignatius Catholic High School in San Francisco, whose mantra is service to others. He carried this passion to serve others into his choice of medicine as a career. As fate would have it, he completed his residency in internal medicine at the University of California at San Francisco in 1981 just when the first cases of what would soon be called AIDS were reported by the Centers for Disease Control and Prevention (CDC). And so, 32 years ago, unbeknownst to him at the time, his bona fides to be the head of PEPFAR began to take shape.

Eric specialized in infectious diseases and spent the next several years as a clinician providing skilled and compassionate care for AIDS patients in the trenches at the San Francisco General Hospital. At that time, I was establishing the AIDS research program at the National Institutes of Health (NIH) and heard much about the work of Eric and his colleagues, who had developed a national model for the care of patients living with HIV infection. In 1987, Eric was appointed Associate Medical Director of San Francisco General Hospital’s AIDS Clinic where, among other innovations, he developed a paradigm for the care of HIV infection in injection drug users. I had met Eric in my visits to San Francisco and admired him and what he was accomplishing -- mostly from a distance. But then in 1991, San Francisco gave him up to the nation and the world when he arrived in Washington to begin his government career, first as Director of HIV Services at the Health Resources and Services Administration (HRSA). It was at this point that I began to appreciate this extraordinary man as our interests and activities overlapped and synergized.

While at HRSA Eric administered the newly authorized Ryan White Care Act and played a major role in its enduring success. In 1994 he became director of the Office of HIV/AIDS Policy at the Department of Health and Human Services (HHS) where he helped to steer the federal HIV/AIDS budget and navigated a host of AIDS-related policy issues. In 1995, when it became clear that the nation and the world needed guidance on how best to use the newly developed, life-saving anti-HIV drugs, Eric created the DHHS Panel on Clinical Practices for the Treatment of HIV Infection. I had the privilege and honor of being appointed by HHS Secretary Shalala and by Eric to be the first co-chair of that Panel. This gave me the chance to work even more closely with Eric and in that context our friendship blossomed. In 1997 Eric took on the additional responsibility as interim director of the National AIDS Policy Office in the White House, reporting directly to President Clinton. His many accomplishments in these positions were critical, from establishing the Minority AIDS Initiative, to comprehensively assessing the evidence on syringe exchanges for HIV prevention, to expanding resources for HIV research and clinical care.

At the end of the Clinton administration, having dramatically improved HIV policy in the United States, Eric turned his attention to global HIV issues and in 2001 became the CEO and Chief Medical Officer of Pangaea Global AIDS Foundation. It was at Pangaea that Eric fortified his expertise in international health issues, which I think of now in retrospect as his “spring training” for the major leagues of PEPFAR. At Pangaea, Eric was highly influential in the establishment and implementation of HIV treatment programs in Rwanda, South Africa, China and Ukraine. I kept in close contact with Eric during those years, but missed the continual interactions that we had during the Clinton administration.

Then, in June 2009 my friend returned to Washington, D.C. as the U.S. Global AIDS Coordinator and head of PEPFAR, to the great benefit of the global AIDS community. So, Eric clearly did not just drop out of the sky into these positions. In many ways, he had spent his entire professional life training and preparing for this mission.

Eric’s four-plus years as head of PEPFAR were nothing short of spectacular. Under his leadership, millions of lives were saved, and the notion of an “AIDS-free generation” is no longer a fantasy, but an attainable goal. His masterful guidance of PEPFAR through the transition from an emergency measure to a sustainable program based on the concept of country ownership was accomplished during a period of severe fiscal constraint, and will go down as a textbook example of how to manage the evolution of a massive global health program. In addition, his emphasis on the concept of “implementation science” in the PEPFAR dialogue has enhanced greatly the efficiency of the program. Eric’s accomplishments with PEPFAR will no doubt be discussed and taught in schools of public health throughout the world.

The only thing that lessens my sadness about Eric’s departure from Washington is the fact that, after much personal sacrifice, he will return to San Francisco where he will be able to spend much more time with his family, his wife Nancy and his children Eric and Zoe.

Just a final note about Eric, the man. Despite his exalted positions and amazing accomplishments, he has remained one of the most modest, humble and self-effacing individuals I have ever met. He is a model of integrity and honesty, kind, generous and with a burning compassion for the suffering of others -- someone whom you would want your children to emulate.

The global AIDS community thanks Eric for a trailblazing run as U.S. Global AIDS Coordinator and for a career devoted to helping people living with HIV/AIDS and putting an end to this modern-day plague. We will miss him greatly, and wish him enormous success in the next stage of his extraordinary career.