Remarks at Swearing-in Ceremony for Ambassador-at-Large and Coordinator of the USG Activities to Combat HIV/AIDS Deborah Birx

John Kerry
Secretary of State
Benjamin Franklin Room
Washington, DC
April 25, 2014

MR. SCHMIT: Distinguished guests, ladies and gentlemen, good morning. I’m Nick Schmit, Assistant Chief of Protocol, and it’s my pleasure to welcome you to the Department of State’s Benjamin Franklin room for the swearing in of Deborah L. Birx as the next Ambassador-at-Large and United States Global AIDS Coordinator. (Applause.)

We are privileged to have the Secretary of State, the Honorable John Kerry, officiating our ceremony this morning and we are so pleased to welcome Ambassador Birx’s family here today, including her parents Donald and Adele and her daughters Danielle and Devynn. I would also like to recognize their longtime family friend, Father Dan McDonald, as well as Deputy Secretary of State Heather Higginbottom, Administrator Raj Shah from USAID, and members of the diplomatic corps present today. Please join me in extending a warm welcome to all of our special guests. (Applause.)

We will begin our ceremony this morning with an invocation by Father Dan McDonald followed by remarks by Secretary Kerry, the administration of the oath of office, the signing of the appointment papers, and then conclude with remarks by Ambassador Birx. It is now my privilege to introduce Father McDonald.

FATHER MCDONALD: Good morning.

AUDIENCE: Good morning.

FATHER MCDONALD: I understand originally that Dr. Birx had requested that Pope Francis – (laughter) – do this invocation. But he was a little occupied, so I was sent instead. (Laughter.)

The faces of AIDS, they’ve changed many times through the years. First, I remember there was fear. Then there was a certain reserve. The tragedy of it was another face. Hope then started to emerge, and the realization that there was a long journey ahead, the waiting.

A Jesuit scientist wrote the following words, and they are words about process and about the – what happens in the process: Above all, trust in the slow work of God. We are quite naturally impatient in everything to reach the end without delay. We should like to skip the intermediate stages. We are inpatient of being on the way to something unknown, something new. And yet it is the law of progress that it is made by passing through some stages of instability – and that it may take a very long time. And so I think it is with you; your ideas mature gradually. Let them grow. Let them shape themselves without undue haste. Don’t try to force them on, as though you could be today what time – that is to say grace and circumstances acting on your own goodwill – will make of you tomorrow. Only God could say what this new spirit gradually forming within you will be. Give God the benefit of believing that God’s hand is leading you and accept the anxiety of feeling yourself in suspense and incomplete.

We ask the Lord’s blessing today for the gift of healing, the gift of prophecy, the gift of patience, and being in God’s hand for Dr. Birx. And let us all say Amen.


MR. SCHMIT: Thank you, Father McDonald. It is now my honor to introduce the Secretary of State. (Applause.)

SECRETARY KERRY: Thank you very much. Thank you very much, Father McDonald for that invocation. I couldn’t help but as I heard you say we’re inpatient to pass by the intermediate stages and get to the end, I got to tell you, the older I get the longer I cling to the intermediate stages, folks. (Laughter.)

I am really honored to be here, as all of you are. And I’m very privileged to come here and meet Deborah’s personal cheering corps. (Laughter.) A lot of energy here, a lot of enthusiasm. (Cheers and applause.) It’s really great to see and great to feel and great to know, because it’s a ratification of the choice that President Obama and I have made. I couldn’t be more thrilled than to swear in one of our most committed champions in the fight against HIV/AIDS, Dr. Deborah Birx. (Applause.)

And I’m particularly pleased to welcome her very modest family that’s here – (laughter) – enormous. We’re really happy to welcome Dr. Donald and Adele Birx, her parents, her brother Donald, and her daughters, Danielle and Devynn. And we’re really happy. Where are they? They’re still over there. They’re going to come up here afterwards. All right. Welcome. (Applause.)

Also very happy to recognize our AID, USAID, Administrator Dr. Raj Shah and Dr. Frieden and Ambassador Eric Goosby, who’s somewhere here. Where is Eric? There he is. (Applause.) I’m really pleased to see Eric here. What a privilege it was to work with him when I was in the Senate and was able to champion this effort as a senator. And frankly, I was sort of jarred and crestfallen when I knew we were going to lose him. But on the other hand, I think he would agree we have found the right champion to fill his shoes. And I am excited to have all of this courageous group of AIDS warriors here today. I know it means a great deal to Debbi that you’re all here. So thank you for coming. (Applause.)

I won’t dwell too long on the fact that this Navy man had to go to the U.S. Army to find somebody to – (laughter) – it’s just a mark of inter-service cooperation, folks. (Laughter.) But I looked at Debbi’s CV, and I knew almost instantly, before I even met her. And I had other recommendations, including a daughter who is involved in global health who knew of her reputation and thought the world of her.

But I remember looking through her resume as I sat in my office, before I had the privilege of having a talk with her about taking on this job, and I saw that there was a couple of interesting parallels. In 1985, Debbi started as Assistant Chief of the Hospital Immunology Service at Walter Reed Medical Center. And I thought, (inaudible)1985, that was when I started in the United States Senate. And at that time, I thought about what AIDS meant – the word AIDS meant in 1985. Back then, it was a death sentence, and it was back during the time when many politicians weren’t even comfortable talking about it.

In the 1990s, Debbi helped develop the Thai vaccine trial, which was the first clinical HIV/AIDS research to show real potential. And by the 1990s, we in Congress had graduated from a fear and a paralysis to some degree and even a politicization to a certain degree. We were able then to put AIDS into a sentence: “AIDS in Africa.” I see my old friend Jim Jones standing out here in front, who was my – one of my key aides, along with Nancy Stetson, who helped us write the earliest AIDS legislation. And when said – AIDS in Africa – it was still a looming death sentence for a continent at that time. And thank God people like Debbi and Jim and Nancy and a lot of other people decided that was simply unacceptable.

In 1998, Debbi was serving as the director of our military’s HIV Research Program at Walter Reed. And that same year, Bill Frist and I joined together on a comprehensive HIV/AIDS bill that actually laid the foundation for what become PEPFAR.

And in 2007, Debbi was director of the Centers for Disease Control and Prevention Division of Global HIV/AIDS. And 2007 happened also to be the year that my wife and I, Teresa and I, traveled to South Africa and went to the Umgeni School in Durban, South Africa. And I saw firsthand there the courage of many single mothers who were scratching out subsistence in mud houses. And I met young kids, in their early teens, who had become, because of the death rate, caretakers for a family, and in many cases caretakers for an older aunt or grandmother or somebody else who had contracted AIDS. And so many husbands were lost to this horrific disease.

So Debbi and I have actually traveled many of the same roads together in this fight, along with Eric and others. And I am very, very proud that now we will be fighting side by side in her new role as our Global AIDS Coordinator.

In so many ways, Debbi embodies the best of what it means to be a pioneer, to be a practitioner, and a public servant all rolled into one. She’s a pioneer as the first woman and the first veteran to take this post on. (Applause and cheers.) But I think all of you know she’s also the gold standard for put-your-head-down, get-it-done – (laughter) – public service. And I’ve heard it’s pretty common to get a call from Debbi on Monday about a problem in a Sub-Saharan African nation, and then you get an email from her on Tuesday, and she’s already flown out there and she’s on the ground and working. (Laughter.)

The apple actually doesn’t fall very far from the tree when it comes to that, folks. Her parents got a call the day that she was going to be sworn in – the day before she was going to sworn in at her private swearing-in, so she was official and could go out and do stuff, so she then had time to invite all of you to come. (Laughter.) And so they got the word at their home in Mechanicsville, Pennsylvania, and they were on the road by 4 a.m. (Laughter.) And wobbly, tired, and unbowed, they arrived here. They drove all night. They made it to D.C. in time for the swearing-in.


AMBASSADOR BIRX: Almost 90. Six months.

SECRETARY KERRY: Almost 90, almost 90, six months. (Applause.) So I have to tell you, that’s why I was a little scared to tell Debbi that I was going to Africa next week, because I figured she’d be on a plane, miss her own swearing-in, and go out there to meet me or something. (Laughter.)

The truth is all of you know Debbi’s the perfect person to take on this job because we need somebody who can act with urgency. This is urgent. (Applause.) And because beating AIDS means demanding concerted action from all of us.

First, we need to continue to make strategic and creative investments based on the latest science and on the best practices. In a tight budget environment, every dollar counts. And that’s why we need to continue to set benchmarks for outcomes and put our weight behind HIV prevention, treatment, and care interventions that we know work.

Second, we need to focus on the impact of HIV/AIDS on women and girls. (Applause.) And we know that HIV remains the leading cause of disease and death for women of reproductive age in low and middle-income countries. We also know that women and girls represent nearly 60 percent of people living with HIV in Sub-Saharan Africa. And that has to change. But I think we’re all proud to know that doing what we’re doing, and if we follow through with what we’re doing and do it well, we are on the cusp of knowing that we will have a first-generation of AIDS-free children as a result of what we’re doing. (Applause.)

And third, we need to promote greater accountability and transparency through our new Country Health Partnerships. South Africa, Rwanda, Namibia are among the nations on the front lines of this transformation. And these countries provide a model for how PEPFAR is transitioning from providing direct aid to delivering support for locally run, self-sustaining efforts. And we need to back these efforts up every step of the way, and Debbi and I intend to do everything we can to do that.

So for Debbi, the last thing I’ll say to you all is that taking the fight to AIDS is not simply a career. It really is a calling. And there’s a reason that it’s more than just a career.

Back in the spring of 1983, Debbi was at Walter Reed Hospital for the birth of her eldest daughter, and she had lost a lot blood during the delivery, and the obstetrician ordered a transfusion. (Laughter.)

AMBASSADOR BIRX: (inaudible) just gave him that story? (Laughter.) No one knows that story. (Laughter.)

SECRETARY KERRY: I’ve got news for you. They’re about to. (Laughter and applause.)


SECRETARY KERRY: But Debbi had read a report weeks earlier about a new disease that no one knew much about, but the risks of a blood transfusion were very, very clear to her. And literally, just before she passed out from pain, Debbi screamed: “Do not let them give me blood.” (Laughter.) Her husband refused the transfusion, and it is a mighty good thing that he did. Because the hospital learned later that that the blood of her blood type – that they would have used – was contaminated with HIV.

That was Debbi’s first brush with AIDS. And it literally changed her. It made her think hard not just about the perils of this new disease, but about her responsibility to fight it.

So I am very proud, as all of you are, of the miles that Debbi has traveled already in this journey. More importantly, I am really excited about the next miles that we will be traveling together over the coming years.

It’s now my great privilege to make this official using the family Bible, which I had the privilege of signing a little while ago. It has all the births and deaths and marriages of the Birx family carefully inscribed in its pages. And you’ll see it’s pretty sizeable. (Laughter.) It’s a big family. It’s a big family, folks. All right. Are we ready?

[The oath was administrated.]

SECRETARY KERRY: Congratulations. (Applause and cheers.)

MR. SCHMIT: Dr. Birx will now sign her appointment papers.

[The appointment papers were signed.]

SECRETARY KERRY: Ladies and gentlemen, Ambassador Deborah Birx. (Applause and cheers.)

AMBASSADOR BIRX: Thank you. Well, this is a lifetime of people, definitely a lifetime of people. And as I look out in this incredible room, I’m just deeply humbled and deeply grateful for the kind comments of the Secretary, although I have no idea how he got that story. (Laughter.) He’s got good intel. (Laughter.)

We have all crossed paths in our collective march towards achieving an AIDS-free generation over the years. My family, represented here by my parents, you taught me to live a life focused on others. My brother, however, taught me how to be tough. (Laughter.) My two amazing daughters, your support and sacrifice enabled me to work tirelessly to fight AIDS, all those years I was gone when you were small.

My friends, longtime and recent, including my friend who’s here from second grade. Yes, we’ve been friends for more than 50 years. I know you’re calculating that right now. (Laughter.)

My colleagues from so many sectors and walks of life, both in the United States and around the world, from which I have learned so much and continue to learn, I am honored and privileged to work with all of you. And it’s such an honor to have Administrator Shah here, Dr. Frieden, Ambassador Goosby, Dr. Fauci, and Dr. Tremont.

The community, both domestic and global, you’ve been the backbone of the response. Before government engagement, you were there, the voice and faith of the people. You hold us accountable to ensure that everything we do truly meets the needs of those we serve.

The United States political leadership across multiple administrations and congresses – and you heard today from Secretary Kerry – for defying the conventional wisdom and emboldening all of us to take new risks and make history, from the Ryan White Act to the LIFE Initiative, to the first global AIDS bill that you heard from then Senator Kerry and Senator Frist, to the launch of PEPFAR by President Bush, to the reauthorization twice by Congress in 2008 and 2013, we are deeply blessed with continued strong bipartisan support, and more importantly, deep and continuing interest in our work.

Time after time, our leaders have refused to take no or the comment that it could be impossible for an answer and instead pushed us to even greater heights. I am particularly grateful to President Obama for his bold leadership, for always pushing us to aim much higher, and his targets in World AIDS Day in 2011, which we thought at the time seemed visionary and impossible, but were achieved by many of those standing before me today. I’m also deeply grateful for the faith that he has put in me by this appointment.

And of course, to Secretary Kerry, who you heard of his amazing, longstanding, and unyielding commitment to changing the course of the epidemic through the decades. (Applause.) And equally for providing a vision for how to make it happen. I have told the staff in the last three weeks on the job that I’ve never been in a position to have this level of secretarial support. And I then follow with: And much will be expected of all of us. (Laughter.)

Together, we have shared tears and triumphs and everything in between. Many of you remember the darkest days of the epidemic, when people living with HIV who knew they would meet the same very fate stood at the bedsides of friends and held their hands while they lay dying because we did not have treatment.

The community most impacted by this disease mobilized to create the AIDS service organizations that remain the backbone of our response today. And here in the audience, I see another strong member of that community, who when PEPFAR first started I was out in Kericho, Kenya. And the matrons at the hospital were turning still away patients because they didn’t believe that any drug could save the patients that they had been confronted with for the last 15 years, wheeled to the gates of the hospital in wheelbarrows and turned away with the statement it’s not worth our investment.

So when I would take to the patients, they would say, as Secretary Kerry said, it’s a death sentence, it’s a death sentence, everybody should go away and die at home. So I asked two colleagues of mine, both of which were HIV positive, to come to Africa with me, to show them that you could live successfully with this disease. Well, they didn’t have very many CD4 cell counts. That’s what keeps your immune system going. And when they accepted, unconcerned about their own health, I got calls from about 150 people who said how dare you take these people to Africa and subject them to such assaults on their immune system which doesn’t exist. But they went with me and they went from community tent to community tent, showing people that you could live successfully with HIV. People came from all over the hillsides to touch them, to realize that there was hope. That day, the nurses began admitting people to the hospital to receive lifesaving treatment.

PEPFAR – and at the very heart of the AIDS response, it has always been about people, people who do the work, people who make the work possible, and most importantly, the people we serve. From the very beginning of PEPFAR, it’s been a bold experiment, and I think many in the room would say a wild ride – (laughter) – but incredibly important. And the results that we have achieved are breathtaking. And indeed, the epidemic is in retreat in dozens of countries.

PEPFAR has brought together the best and the brightest of the U.S. Government and all it has to offer with a whole-of-government approach with a common goal. To be able to work beside the Department of State, USAID, Department of Defense, HHS, Peace Corps, Labor, and Commerce and bring together that strength and intellect every day to address such an incredible disease and ability to fight it has been such an inspiration for me. I’ve been able to serve in many of those agencies, and to be able to be now in the State Department and working with them again in this new role has been very exciting to me.

PEPFAR has also taken groundbreaking scientific discovery from the bench through the policies and into the field for rapid implementation and scale-up from the very beginning. And many people in this room were responsible for that. They went into places where there wasn’t running water; it didn’t stop them. They went into places where there was only one nurse, and it didn’t stop them. And they went into places where their own physical safety was at risk. And they did that to combat this disease.

This epidemic has also forced us to address stigma and discrimination in unprecedented ways. But sadly, the dark clouds are gathering in parts of Africa and threaten the very rights of the many people that we serve. This could unravel our hard-fought gains, and we must continue to fight against this issue.

You heard from Secretary the vision moving forward. Although we’ve made tremendous progress, there is still work to be done. And this means, as he said, focusing on the impact of our work, the accountability and transparency. But our challenge moving forward is still to maintain that focus and effort. If we begin to drift, to lessen our aspirations, to leave behind what science, the community, and those that we have cared for have all taught us, we risk not only squandering this amazing investment by the taxpayers of the United States, but also the progress we made, and we will have failed to capture this opportunity which will not come again. (Applause.) Thank you.

We have invested so much and we’ve come so far. We owe it to everyone who still needs our service, and most importantly to those that came before us and have died from this disease to finish the job. (Applause.) When I reflect on the journey of PEPFAR – thank you – and the boarder journey that we’ve all taken together for the last 30 years – and I see many of you in the audience that have been there with me – reminded of Nelson Mandela that always said it’s impossible until it’s done. And this can be done.

So as we focus our collective energies and assets to deliver on the challenge that President Obama and Secretary Kerry have put before us and a world that is possible to achieve an AIDS-free generation, we must always keep this in the perspective that we can move forward. Together we have made the impossible possible. And now we must come together to do it again. And it’s because of you all and everybody who has supported me that I am really excited but deeply humbled to assume this role. Thank you so much. (Applause.)