WASHINGTON – President Donald Trump’s announcement Wednesday that his vice president will lead the administration’s response to the coronavirus put the spotlight on Mike Pence’s handling of a major health crisis when he was Indiana’s governor.
Critics have faulted Pence for what they call his slow and inadequate response to the nation’s first HIV outbreak linked to the injection of oral painkillers in 2015.
Pence initially opposed allowing a clean-needle exchange that health officials advocated to slow the spread of infection. Studies in medical journals have said the outbreak could have been prevented if the state had acted faster.
“As Governor of Indiana, an HIV/AIDS epidemic flourished until he allowed public health—not ideology—to direct policy & response,” tweeted Leana Wen, the past head of Planned Parenthood who now teaches at George Washington School of Medicine and Health Sciences. “I hope he now follows the guidance of the exceptional career public health leaders @CDCgov & in the admin.”
Vermont Sen. Bernie Sanders, who is running for the Democratic nomination to challenge Trump, tweeted that the president’s response plans so far include having “VP Pence, who wanted to `pray away’ HIV epidemic, oversee the response.”
Southeastern Indiana became the face of the nation’s opioid addiction in 2015 after an unprecedented epidemic of HIV associated with intravenous drug use.
Addicts were injecting a liquefied form of the potent painkiller Opana more than 10 times a day. At one point, the cases of new HIV infections in rural Scott County exceeded the number of people infected with HIV through injection drug use in New York City in the previous year.
The outbreak highlighted the weaknesses in the state’s health infrastructure. Indiana ranked among the states with the fewest drug treatment providers and the lowest public health spending.
The state also banned needle exchange programs.
The Centers for Disease Control and Prevention strongly advocated Indiana remove the ban. But Pence had been opposed to needle exchanges as anti-drug policy.
After weeks of discussion, Pence declared a public health emergency for Scott County that allowed for a needle exchange.
“I do not enter into this lightly,” he said at the time. “I don’t believe effective anti-drug policy involves handing out drug paraphernalia.”
A 2018 study by the Yale School of Public Health that appeared in The Lancet found that the number of HIV infections – 235 – could have been drastically reduced if the state had acted faster.
A 2016 study published in the New England Journal of Medicine concluded the crisis had been preventable.
“Substantial barriers to syringe exchange (i.e. laws prohibiting syringe exchange or syringe possession, lack of funding or of a community organization to implement the syringe exchange, and stigma) existed in this community before this outbreak,” the article said.
The study also noted that free HIV testing had not been available in the community since a Planned Parenthood clinic closed in 2013.
Federal and state funding cuts had prompted Planned Parenthood to close five rural clinics in Indiana.While a Planned Parenthood official said in 2015 that she couldn’t make a direct link between the closure and the outbreak, one of the centers had been providing HIV tests in Scott County and could have reported any positive results to the state.
Paul Halverson, dean of Indiana University’s Richard M. Fairbanks School of Public Health, has given a lot of credit for Pence’s turnaround on needle exchange programs to Jerome Adams, who was Indiana’s state health commissioner and is now the surgeon general. Halverson has said Adams helped Pence “understand the scientific aspects related to syringe exchanges.”
Sen. Jeff Merkley, D-Ore., tweeted Wednesday that Pence “put ideology over science & contributed to one of the worst HIV crises his state had ever seen.”
“We need competence & science driving our response – that’s not the VP’s record,” Merkley added.
At the White House news conference announcing the appointment, Pence did not respond to a Yahoo News reporter’s attempt to ask him about his handling of the HIV outbreak.
Trump lauded Pence’s record on health care when he was governor of Indiana.
“He is really very expert at the field,” Trump said. “Anybody that knows anything about health care, they look at the Indiana model.”
Pence did mention a different health issue he dealt with as governor. In 2014, the first Middle East Respiratory Syndrome (MERS) case in the United States emerged in Indiana.
Pence said he learned from that experience the importance of presidential leadership and of partnerships with state and local governments and health authorities in responding to dangerous infectious diseases.
Pence said he will work with the administration’s existing coronavirus task force to bring to Trump the “best options for action to see to the safety and well being and health of the American people.”
Contributing: The Indianapolis Star and The (Louisville) Courier-Journal.