WASHINGTON — Deborah Birx was visiting South Africa in her role as the State Department’s global ambassador for AIDS prevention and treatment when she got an urgent call from Secretary of State Michael Pompeo to fly home to Washington immediately.
Pompeo, who famously recalled the U.S. ambassador to Ukraine because President Donald Trump didn’t trust her, had a far different message for Birx, according to people familiar with the decision: the president needed her to coordinate the nation’s response to the coronavirus.
Birx, 63, a medical doctor and retired Army colonel, was appointed to her ambassador’s post under President Barack Obama — and that’s usually enough to doom someone’s career in the Trump administration. But it’s a measure of her stature, and her political savvy, that she’s been elevated to a central role in the current administration’s response to a public health crisis.
“Her reputation is stellar,” said Jeremy Konyndyk, senior policy fellow at the Center for Global Development. She’s a natural choice, he said, “if you’re looking to try to bring a competent steady hand into this process and someone with a proven track record on global health matters.”
Birx served for nine years as director of global efforts to fight HIV and AIDS at the Centers for Disease Control and Prevention, a key agency in tackling the current crisis. She was named to her State Department post in 2014.
While Vice President Mike Pence has become the spokesman for the administration’s effort to halt the spread of the coronavirus and Trump riffs on what he’s called his “hunch” that it won’t prove as deadly as some, Birx has been leading the scientific and medical efforts to stem the disease by working with the agencies and experts she knows well.
Matt Pottinger, the deputy national security adviser, recommended her for the position, according to a person familiar with the decision.
Birx has had to “navigate different bureaucracies” in the military and at the CDC, and that’s valuable because it’s “probably her biggest challenge now,” said Jeffrey Crowley, who was director of the White House Office of National AIDS Policy during the Obama administration.
She’s also shown she’s politically astute. As the U.S. envoy on AIDS, Birx chose the Vatican as a setting for a conference where pharmaceutical and diagnostic companies would find it hard to say no to her pleas for more spending on drugs to treat HIV-positive babies.
Birx won confirmation for the State Department position thanks to support from Republicans who told the Obama administration her no-nonsense approach made her a candidate they would accept, according to a person close to her.
During the Trump administration, Birx went toe-to-toe with international organizations by refusing to allow funds from her office to go to the leftist Maduro regime in Venezuela.
“She was a forceful advocate for President Trump’s policy that not a single dime of American taxpayer money should go toward propping up the Maduro regime,” said Matt Mowers, an aide in Trump’s 2016 campaign who was Birx’s chief of staff for almost two years.
She’s “famous for bringing a big pile of slides” to presentations for lawmakers, staff and community members to show what’s being learned “about the dynamics of infection on the ground and how that can be used to drive better decision-making,” said Chris Collins, president of Friends of the Global Fight Against AIDS, Tuberculosis and Malaria, who began working with Birx more than 20 years ago.
At the State Department in the Obama administration, Birx oversaw a $6.8 billion annual budget for the President’s Emergency Plan for AIDS Relief, or Pepfar. She braved criticism for cutting off funds to clinics around the world that failed to find HIV cases.
“If you had a Starbucks that never sold coffee, you wouldn’t keep the site open,” Birx, who has also been a top research official at Walter Reed Army Medical Center, said in a 2015 interview. “It’s not that we’re abandoning sites, but we’re saying, ‘Let’s go where there’s HIV, focus our resources there.’”
Birx “has deep experience in public health going back decades, including in the beginning of scientific efforts to find an AIDS vaccine in the 1980s,” according to Mark Barnes, a Boston lawyer who was the first executive director of the Harvard Pepfar program.
She also turned to companies — including Starbucks Corp. and Nike Inc. — for ideas about how to deliver effective messages about disease prevention and treatment.
Birx was able to get cooperation both within the U.S. and in other countries for her changes in delivery of resources for HIV and AIDS, said Crowley, who is now director of infectious disease initiatives at the Georgetown University O’Neill Institute for National and Global Health Law.
In the end, he said, Birx is fearless about sticking to what data dictates regardless of the politics and that’s helped her retain her “credibility within the administration and among community advocates.”
At a press briefing, Birx revealed a little about personal life, saying she and her husband live in a “multi-generational household” with her parents, who are 91 and 96, her daughter and son-in-law and their children. She said it’s been compared to the television sitcom “Full House.”
Bloomberg writer Jeannie Baumann contributed to this report.