Robert Ray Redfield Jr.[1] (born July 10, 1951) is an American virologist. He is the current Director of the Centers for Disease Control and Prevention, and the current Administrator of the Agency for Toxic Substances and Disease Registry, having served in both positions since March 2018.[2][3]

Robert R. Redfield
Robert R. Redfield.jpg
Director of the Centers for Disease Control and Prevention
Assumed office
March 26, 2018
DeputyAnne Schuchat
Preceded byBrenda Fitzgerald
Personal details
Born (1951-07-10) July 10, 1951 (age 68)
EducationGeorgetown University (BS, MD)
Military service
Allegiance United States
Branch/service United States Army
Years of service1977–1996
RankUS-O6 insignia.svg Colonel
UnitMedical Corps

BackgroundEdit

Redfield's parents were both scientists at the National Institutes of Health, and Redfield's career in medical research was influenced by this background.[4] At college Redfield gained experience working in laboratories at Columbia University where the involvement of retroviruses in human disease was investigated.

EducationEdit

As an undergraduate, Redfield attended Georgetown University, obtaining a Bachelor of Science from the university's College of Arts and Sciences in 1973. He then attended Georgetown University School of Medicine, and was awarded his Doctor of Medicine in 1977. Redfield's medical residency was undertaken at the Walter Reed Army Medical Center (WRAMC) in Washington, D.C., where he completed his postgraduate medical training and internships in internal medicine (1978–1980). By 1982 at WRAMC Redfield had completed clinical and research fellowships in infectious diseases and tropical medicine.[5]

Early medical careerEdit

Redfield continued as a U.S. Army physician and medical researcher at the WRAMC for the next decade, working in the fields of virology, immunology and clinical research. During this period he collaborated with numerous teams at the forefront of AIDS research, publishing several key papers and was a strong and innovative advocate for strategies to translate knowledge gained from clinical studies to the practical treatment of patients afflicted by chronic viral diseases.[5]

Redfield retired from the army in 1996 as a colonel,[6] to concentrate on setting up a multidisciplinary research organization dedicated to developing research and treatment programs for chronic human viral infection and disease. To this end, he co-founded the Institute of Human Virology based at Maryland, together with his HIV research colleagues Robert Gallo, the co-discoverer of the HIV retrovirus, and noted viral epidemiologist William Blattner.[4]

CareerEdit

Redfield has served as the director of the CDC since March 26, 2018.[7] In his inaugural address to the CDC Redfield said "[The agency is] science-based and data-driven, and that's why CDC has the credibility around the world that it has.”[8]

Before joining CDC, he was a tenured professor of medicine and microbiology at University of Maryland, Baltimore, chief of infectious disease, vice chair of medicine and a co-founder and associate director of the Institute of Human Virology (IHV) at the University of Maryland School of Medicine.[4] Dr. Redfield is known for his pioneering contributions in clinical research, and in particular for his extensive research into the virology and therapeutic treatments of HIV infection and AIDS.

During the 1980s in the early years of investigation into the AIDS pandemic Redfield led the research that was the first to conclusively demonstrate that the HIV retrovirus could be heterosexually transmitted.[9] He also developed the staging system now in use worldwide for the clinical assessment of HIV infection.[10] Under his clinical leadership at the University of Maryland the patient base grew from just 200 patients to approximately 6,000 in Baltimore and Washington, D.C., and more than 1.3 million in African and Caribbean nations.[11] Under his research leadership his clinical research team successfully competed for and won over 600 million dollars of research funding.[12]

Awards and serviceEdit

As a physician-scientist, Redfield has acquired several awards over the course of his research career include an honorary degree from the New York Medical College, a lifetime services award from the Institute for Advanced Studies in Immunology and Aging, and the Surgeon General's Physician Recognition Award.[5] In 2012, along with William Blattner, he was named entrepreneur of the year at the University of Maryland.[13] In 2016 he was named the inaugural Robert C. Gallo, MD Endowed Professors in Translational Medicine.[14]

Redfield also 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.

ControversyEdit

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. As Randy Shilts, author of And The Band Played On writes in his followup book 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.[15]

Then, as 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 on the preliminary data. 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 would be a good sign of vaccine effectiveness. The vaccine later turned out to be ineffective. Many researchers said that Redfield had made a reasonable interpretation of the preliminary data by selecting only 15 patients who had been on the vaccine for 18 months, but a US Air Force scientist Major Craig Hendrix, MD (now at Johns Hopkins) said that he committed scientific misconduct by selecting data that was favorable to the vaccine.[16]

In 1993, a U.S. Army investigation determined that Redfield had not committed scientific misconduct and he was promoted to colonel thereafter. Redfield is quoted in the comprehensive book on the controversy Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine as saying of his false accusers "I am disappointed in the institutions for not holding the individuals accountable for what I consider conduct unbecoming of an officer." Importantly, Redfield carried on his studies of the gp160 vaccine beyond his controversial abstract presentation and carried it through phase II publishing the results in the Journal of Infectious Disease in 2000.[17] Subsequently, over 50 therapeutic vaccine trials have been performed (and all have failed to show efficacy), and not until recently has one been shown to have some efficacy.[18]

Redfield's multi site study, a collaboration between the Department of Defense and the National Institutes of Health, laid the groundwork for future vaccine development and provided a better understanding of the biologic basis of HIV infection and its interaction with the host immune system.[17]

The investigation did say that he had an "inappropriate" close relationship with the non-governmental group "Americans for a Sound AIDS/HIV Policy" (ASAP), which promoted the gp160 vaccine.[19][20] Redfield served on the board of ASAP, which gay groups criticized for anti-gay, conservative Christian policies, such as abstinence-only prevention.[21] While Redfield is a devout Catholic, he has publicly supported the use of condoms and denies ever promoting abstinence-only interventions.[22]

Appointment to the CDCEdit

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 his own boss, Alex Azar, the Secretary of Health and Human Services and former president of the U.S. division of Eli Lilly and Company. Redfield's previous salary and bonuses at the University of Maryland totaled $757,100.

While it is true that the heads of the FDA and HHS took larger pay cuts, their salaries are strictly dictated and set in stone by Congress; the salary of the CDC director is not.[23] 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 C.D.C.".[24] Redfield's initial salary, however, was in line with many other physician-scientists in government. While the NIH director Francis Collins received a salary less than $200,000 a year and is dictated by Congress,[23] his deputy institute director of NIAID made $384,624 in 2016.[25]

Personal lifeEdit

Redfield is married to Joyce Hoke Redfield. They met while delivering babies when he was a medical student and she was a nursing assistant.[26] They have 5 children and 9 grandchildren.

Redfield has a close personal experience with the opioid crisis. Soon after his appointment to the CDC, he stated in an agency-wide address that the opioid epidemic is “the public health crisis of our time. If any of you have tried to access care for addiction in this nation, I can guarantee you it's complicated. It needs to not be complicated.”[27]

NotesEdit

  1. ^ "AIDS researcher Robert R. Redfield selected as CDC director". CBS News. March 22, 2018. Retrieved May 12, 2018.
  2. ^ "CDC Director". Centers for Disease Control and Prevention. March 26, 2018. Retrieved April 7, 2018.
  3. ^ Press, The Associated (March 21, 2018). "Leading AIDS Researcher Selected as CDC Director". The New York Times. ISSN 0362-4331. Retrieved March 21, 2018.
  4. ^ a b c Institute of Human Virology (n.d.)
  5. ^ a b c Medical Institute of Sexual Health (2007)
  6. ^ Thomas, Patricia (September 18, 2001). Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine. p. 417.
  7. ^ Sun, Lena H. (March 29, 2018). "In emotional speech, CDC's new leader vows to uphold science". Washington Post. ISSN 0190-8286. Retrieved March 30, 2018.
  8. ^ Sun, Lena H. (March 29, 2018). "In emotional speech, CDC's new leader vows to uphold science". Washington Post. ISSN 0190-8286. Retrieved March 30, 2018.
  9. ^ Institute of Human Virology (n.d.), Medical Institute of Sexual Health (2007). See also the original papers on the topic, in Redfield et al. (1985a, 1985b).
  10. ^ Institute of Human Virology (n.d.), Medical Institute of Sexual Health (2007).
  11. ^ University of Maryland, Baltimore. "Dr. Robert Redfield, Co-Founder of the Institute of Human Virology at the University of Maryland School of Medicine, to Become CDC Director". University of Maryland, Baltimore. Retrieved May 12, 2018.
  12. ^ "Institute of Human Virology Annual Report 2107" (PDF). Institute of Human Virology. Retrieved May 12, 2018.
  13. ^ University of Maryland, Baltimore. "Past Founders Week Award Winners". University of Maryland, Baltimore. Retrieved May 12, 2018.
  14. ^ University of Maryland, Baltimore. "Two Prominent Institute of Human Virology Researchers Honored With Robert C. Gallo, MD Endowed Professorships in Translational Medicine". University of Maryland, Baltimore. Retrieved May 12, 2018.
  15. ^ Shilts, Randy (June 23, 2005). Conduct Unbecoming: Gays and Lesbians in the U.S. Military/.
  16. ^ Thomas, Patricia (September 18, 2001). Big Shot: Passion, Politics, and the Struggle for an AIDS Vaccine/.
  17. ^ a b Pubmed (2000). "Efficacy testing of recombinant human immunodeficiency virus (HIV) gp160 as a therapeutic vaccine in early-stage HIV-1-infected volunteers. rgp160 Phase II Vaccine Investigators". The Journal of Infectious Diseases. 181 (3): 881–9. doi:10.1086/315308. PMID 10720508.
  18. ^ Science. "AIDS vaccine may be 'functional cure' for some". Science. Retrieved May 12, 2018.
  19. ^ Cohen, J. Army clears Redfield—but fails to resolve controversy. Science August 13, 1993; 261(5123): 824–5. DOI: 10.1126/science.8346432
  20. ^ Political Battle Over an AIDS Drug, By BARRY MEIER, New York Times, Nov. 2, 1993
  21. ^ Concerns About Robert Redfield for CDC. Nominated to head the Centers for Disease Control and Prevention, Dr. Redfield has close ties with anti-gay and anti-PLHIV activists. By Sean Strub, POZ, March 20, 2018
  22. ^ Sun, Lena H. (March 29, 2018). "In emotional speech, CDC's new leader vows to uphold science". Washington Post. ISSN 0190-8286. Retrieved March 30, 2018.
  23. ^ a b Kaplan, Sheila (April 27, 2018). "New C.D.C. Director's $375,000 Salary Under Scrutiny". The New York Times. ISSN 0362-4331. Retrieved April 27, 2018.
  24. ^ Kaplan, Sheila (May 8, 2018). "C.D.C. Director's Salary Is Reduced to $209,700 From $375,000". The New York Times. ISSN 0362-4331. Retrieved May 11, 2018.
  25. ^ "Federal Pay". Federal Pay. Retrieved May 12, 2018.
  26. ^ Kaplan, Sheila (March 18, 2018). "AIDS Researcher Top Candidate to Lead the C.D.C." The New York Times. ISSN 0362-4331. Retrieved May 12, 2018.
  27. ^ Sun, Lena H. (March 29, 2018). "In emotional speech, CDC's new leader vows to uphold science". Washington Post. ISSN 0190-8286. Retrieved March 30, 2018.

ReferencesEdit

Institute of Human Virology (n.d.). "Dr. Robert R. Redfield". Faculty. IHV, University of Maryland School of Medicine. Retrieved September 15, 2008.
Medical Institute of Sexual Health (2007). "Robert R. Redfield. M.D." National Advisory Board Members. The Institute. Retrieved September 15, 2009.[dead link]
Redfield, RR; Markham PD; Salahuddin SZ; Sarngadharan MG; Bodner AJ; Folks TM; Ballou WR; Wright DC; Gallo RC (March 1985). "Frequent transmission of HTLV-III among spouses of patients with AIDS-related complex and AIDS". Journal of the American Medical Association. Chicago, IL: AMA. 253 (11): 1571–1573. doi:10.1001/jama.253.11.1571. ISSN 0098-7484. OCLC 116006679. PMID 2983127.
Redfield, RR; Markham PD; Salahuddin SZ; Wright DC; Sarngadharan MG; Gallo RC (October 1985). "Heterosexually acquired HTLV-III/LAV disease (AIDS-related complex and AIDS). Epidemiologic evidence for female-to-male transmission". Journal of the American Medical Association. Chicago, IL: AMA. 254 (18): 2904–2906. doi:10.1001/jama.254.15.2094. ISSN 0098-7484. OCLC 113563960. PMID 2995695.

External linksEdit