John Nkengasong, of the Africa C.D.C., Will Lead PEPFAR



The Biden administration plans to nominate John Nkengasong, a virologist and director of the Africa Centers for Disease Control and Prevention, to lead the President’s Emergency Plan for AIDS Relief, according to several sources familiar with the matter.

President Biden is expected to make the announcement in the coming days.

PEPFAR is a $7 billion operation that funds and sets goals for AIDS care in many nations, most of them in Africa. Dr. Nkengasong, who was born in Cameroon, is the first person of African origin to head the program, which is housed in the Department of State.

“This is a huge leap forward for the U.S. government to name someone from the region where much of the PEPFAR work is,” said Mitchell Warren, executive director of AVAC, a nonprofit organization promoting H.I.V. treatment worldwide. “It shows a commitment to truly listening to and learning from the people PEPFAR is meant to serve.”

Dr. Nkengasong could not immediately be reached for comment.

The AIDS program was last led by Dr. Deborah Birx, who left in February 2020 to join the White House coronavirus task force. The Biden administration has come under severe criticism for leaving the program leaderless, especially at a time when the pandemic is setting back years of progress against H.I.V.

In July, more than 50 advocacy organizations sent a letter to Mr. Biden calling the delay “unacceptable.”

Compared with 2019, the number of people in 2020 who sought testing for H.I.V. decreased by 22 percent, and the number who opted for H.I.V. prevention services fell by 12 percent, according to a report published this month.

“Deep inequities in access to science, justice and human rights are fueling the H.I.V. pandemic,” said Maureen Milanga, a director of policy at the advocacy group Health GAP in Nairobi, Kenya. Dr. Nkengasong “must put the U.S. global AIDS response back on the front burner.”

Dr. Nkengasong has been the director of the Africa C.D.C. since 2016, when the organization was established. He has decades of experience in global health, with long stints at the World Health Organization and the U.S. Centers for Disease Control and Prevention. The W.H.O. appointed him as its special envoy for Africa during the Covid-19 pandemic.

Several public health experts and activists called Dr. Nkengasong an unexpected but inspired choice.

“He’s a very strong public health leader with many years of experience, and would bring great connectivity to African leaders and community partners,” said Dr. Chris Beyrer, a professor of public health and human rights at the Johns Hopkins Bloomberg School of Public Health. (Dr. Beyrer was on a short list of candidates for the position.)

PEPFAR, the largest public health program in the United States, was started in 2003 by President George W. Bush. Since its launch, the U.S. government has invested more than $85 billion in more than 50 countries, saving an estimated 20 million lives.

Funds distributed by the scheme are used to support prevention programs, testing and antiretroviral therapy for H.I.V. Some directors have been heavy-handed in setting priorities for African nations, so a leader like Dr. Nkengasong who knows and is trusted by Africans is a welcome change, experts said.

“To have somebody who’s a known figure both in the U.S. and around the world, and in Africa, is a sign that they’re taking this seriously — that they understand that raising up African leadership is really important,” said Gregg Gonsalves, a longtime H.I.V. activist and an epidemiologist at the Yale School of Public Health.

Cameroon, Dr. Nkengasong’s country of birth, has a high prevalence of H.I.V. and tuberculosis. And he has been vocal in his support of training local scientists and doctors to lead public health and research in the continent. In 2011, he helped establish the African Society for Laboratory Medicine.

Dr. Nkengasong was knighted in November 2018 by the government of Cameroon for his contributions to public health. He serves as an adviser to the Coalition for Epidemic Preparedness Innovations and the International AIDS Vaccine Initiative, among others. For his leadership in the Covid-19 pandemic, he was included in Time magazine’s 2021 list of the 100 most influential people.

The only downside to Dr. Nkengasong leading PEPFAR is that he is also needed to combat other infectious disease efforts in Africa, Mr. Gonsalves said: “It’s a loss for Africa C.D.C.”




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