Dr. Deborah Leah Birx (born 1956)

Deborah Leah Birx (born April 4, 1956) is an American physician and diplomat who served as the White House Coronavirus Response Coordinator under President Donald Trump from 2020 to 2021. Birx specializes in HIV/AIDS immunology, vaccine research, and global health.^[1] Starting in 2014, she oversaw the implementation of the President's Emergency Plan for AIDS Relief (PEPFAR) program to support HIV/AIDS treatment and prevention programs in 65 countries.^[2][3] From 2014-2020, Birx was the United States global AIDS coordinator for presidents Barack Obama and Donald Trump and served as the United States special representative for global health diplomacy between 2015 and 2021. Birx was part of the White House Coronavirus Task Force from February 2020 to January 2021.^[4][5] In March 2021, Dr. Birx joined ActivePure Technology as Chief Medical and Science Advisor.^[6]

Contents

Early life and education[edit]

Birx was born in Pennsylvania. She is the daughter of Donald Birx, a mathematician and electrical engineer, and Adele Sparks Birx, a nursing instructor.^[7][8][9] Her late brother Danny was a scientist who founded a research company, and her older brother, Donald Birx, is president of Plymouth State University.^[10]

Her family lived in Lancaster County, Pennsylvania, where she attended Lampeter-Strasburg High School.^[9] Growing up, the siblings used a shed behind their family home as a makeshift lab for experiments in astronomy, geology, biology, and on one occasion, a homemade satellite dish antenna mounted on roller skates.^[10]

In Birx's sophomore year, she won third place at the Lancaster City-County Science Fair, and she was featured in a front-page story in the Lancaster New Era with the subheading: Girls Sweep Top 3 Prizes.^[9] She told the Intelligencer Journal that, "third is alright, but I'll be back. I want that first prize." Her junior year she competed in the International Science and Engineering Fair in San Diego.^[10] Her family later moved to Carlisle, Pennsylvania, and she attended Carlisle High for her final year of high school.^[11][12] During her senior year, she competed at the Capital Area Science Fair and was awarded the Grand Prize.^[13]

In 1976, While enrolled at Hershey Medical School, Birx married a fellow medical student Bryan Dudley Raybuck and future cardiologist she met at Houghton College,^[14] and received a Bachelor of Science degree in chemistry, completing her undergraduate studies in two years.^[12] In 1980, Birx earned an Doctor of Medicine from the Penn State Milton S. Hershey Medical Center.^[7]

Career[edit]

From 1980 to 1994, Birx served as an active duty reserve officer in the United States Army. From 1994 to 2008, Birx was active duty regular Army, achieving the rank of Colonel.^[11]

From 1980 to 1989, Birx worked as a physician at the Walter Reed Army Medical Center.^[15] In 1981, Birx completed a one-year internship and did a two-year residency in internal medicine. From 1983 to 1986, she completed two fellowships in clinical immunology in the areas of allergies and diagnostics, where she worked in Anthony Fauci's lab.^[5] From 1985 to 1989, Birx was the assistant chief of the Walter Reed Allergy/Immunology Service. Birx started her career as a clinician in immunology, eventually focusing on HIV/AIDS vaccine research.^[5][15]

From 1986 to 1989, Birx worked at the National Institutes of Health as an investigator specializing in cellular immunology.^[15]

Birx returned to Walter Reed, where from 1989 to 1995 she worked in the Department of Retroviral Research, first as an assistant chief and then as chief of the division. She was lab director in HIV-1 Vaccine Development for a year. Birx became the director of the United States Military HIV Research Program at the Walter Reed Army Institute of Research, a position she held for nine years, from 1996 to 2005. In that position, Birx led the HIV vaccine clinical trial of RV 144, the first supporting evidence of any vaccine being effective in lowering the risk of contracting HIV.^[15]

In March 2020, Birx became a board member of the Global Fund to Fight AIDS, Tuberculosis and Malaria.^[16]

CDC[edit]

From 2005 to 2014, Birx served as the director of Centers for Disease Control and Prevention's Division of Global HIV/AIDS (DGHA), part of the agency's Center for Global Health.^[17]

President's Emergency Plan for AIDS Relief[edit]

In January 2014, President Barack Obama nominated Birx to be the Ambassador-at-Large and U.S. Global AIDS Coordinator as part of the President's Emergency Plan for AIDS Relief (PEPFAR) program.^[18][19]

Birx was confirmed by the Senate by voice vote on April 2, 2014,^[20] and was sworn in two days later.^[21] She described her role as ambassador to help meet the HIV prevention and treatment targets set by Obama in 2015 to end the AIDS epidemic by 2030.^[22] Her role has focused on the areas of HIV/AIDS immunology, vaccine research, and global health issues around HIV/AIDS.^[4] As part of her work with HIV prevention, Birx created a program called DREAMS (Determined, Resilient, Empowered, AIDS-free, Mentored and Safe), a public-private partnership focused on reducing infection rates among adolescent girls and young women.^[23] PEPFAR management under Birx came under scrutiny in a February 2020 audit conducted by the State Department's Office of the Inspector General, with leadership of the program being described as "dictatorial" and "autocratic."^[24]

White House Coronavirus Task Force[edit]

Main article: White House Coronavirus Task Force

On February 27, 2020, Vice President Mike Pence appointed Birx to the position of White House Coronavirus Response Coordinator. As part of this role, Birx reported to Pence on the White House Coronavirus Task Force.^[4][25] Pence called her his "right arm" on the task force.^[26] In televised briefings, Birx interpreted data on the virus, urged the public to practice social distancing, and tried to avoid publicly contradicting Trump, who frequently offered unscientific digressions.^[27][28]

On March 26, 2020, Birx sought to reassure Americans in a press conference^[29] that "there is no situation in the United States right now that warrants that kind of discussion [that ventilators or ICU hospital beds might be in limited supply] ... You can be thinking about it ... but to say that to the American people, to make the implication that when they need a hospital bed, it's not going to be there, or when they need that ventilator, it's not going to be there, we don't have evidence of that right now."^[30]

Birx led the creation of a reopening plan presented by Trump on April 16, 2020, with voluntary standards for states to end coronavirus lockdowns.^[31]

During the state reopenings, Birx warned individuals to continue precautions against the virus, and opposed some non-essential activities such as professional haircuts. "You need to continue to social distance," she said on May 3, 2020.^[32]

In July 2020, a working group convened by Birx ordered hospitals to bypass the Centers for Disease Control and Prevention and instead send all COVID-19 patient information to a database at the Department of Health and Human Services. Some health experts opposed the order and warned that the data might become politicized or withheld from the public.^[33] Birx, who had criticized hospitals and the CDC for being slow to gather data, helped select the data firm Palantir to help run HHS's new system.^[34]

On August 2, 2020, Birx recommended that people living with someone vulnerable to COVID-19 consider wearing masks at home. She said that the United States was in a "new phase" of the coronavirus epidemic that was "extraordinarily widespread".^[35]

On August 10, 2020, Scott Atlas joined the White House, becoming President Trump's top COVID-19 advisor.^[36][37] Afterward, Birx traveled to virus hot spots around the United States to work on mask mandates and social distancing guidelines with state and local officials.^[38] According to CNN, she told a friend that she aimed to take her message directly to the people and sidestep misleading messages disseminated by Atlas.^[39]

Birx visited Minnesota in August and October 2020.^[40][41][42] While in Minnesota, she told Andy Slavitt that she hopes "the election turns out a certain way."^[43][44][45]

In November, an internal report from Birx stated in bold font: "There is an absolute necessity of the Administration to use this moment to ask the American people to wear masks, physical distance and avoid gatherings in both public and private spaces." The report also stated that confronting an emerging wave of the pandemic required "an aggressive and balanced approach that is not being implemented".^[38]

Birx was alternately praised and pilloried by various sides, both for her responses as well as the actions in general of the CDC as well as the coronavirus task force. Critics alleged that Birx minimized the dangers of coronavirus and downplayed equipment shortfalls. She had been the White House's chief proponent for the idea in April that COVID-19 infections had peaked and the virus was fading quickly,^[46] when infections surged afterward.^[47] A board member at the American College of Emergency Physicians, Ryan A. Stanton, said Birx sounded like “the builders of the Titanic saying the ship can’t sink". Birx was also accused of squandering her credibility and bringing her independence into question with her public praise of Trump, whom many believed bungled the coronavirus response.^[48]

In December 2020, Birx indicated that she would retire from government soon after Joe Biden assumed office, stating that she would "stay as long as needed and then retire" and that her tenure had "been a bit overwhelming" and was "very difficult on my family".^[49][50] Birx's announcement came after news broke that she hosted three generations of her own family from two households during Thanksgiving after she had urged Americans to restrict such gatherings to "your immediate household".^[51] On January 20, 2021, her term ended.^[52] Afterwards, Birx stated that she often considered quitting her position as White House coronavirus response coordinator under the Trump administration due to the administration's hyper-partisanship, especially during the 2020 presidential election.^[45][53][54] Birx also asserted that the Trump administration "censored" her "science-based guidance" and that she was also "being deliberately blocked," from appearing on national media outlets for a time.

George W. Bush Institute[edit]

In March 2021, Birx joined the George W. Bush Institute in Dallas, Texas, as a senior fellow, working on initiatives to reduce health disparities and prepare for future pandemics.^{[55][56][57][58]}

Personal life[edit]

Birx lives with her parents, husband, and the family of one of her daughters in a multi-generational home.^[59][60] Birx's husband, Paige Reffe, is a lawyer who held managerial roles in the Carter, Reagan, and Clinton administrations.^[61][62]

Awards and honors[edit]

1989: United States Department of Defense, Legion of Merit^[52]
1991: United States Department of Defense, Meritorious Service Medal, recombinant gp160 vaccine^[63]
2008: Federal Executive Board, Outstanding Manager
2011: African Society for Laboratory Medicine, ASLM Lifetime Achievement Award^[64]
2014: Centers for Disease Control and Prevention, William C. Watson, Jr. Medal of Excellence^[15]
2019: International Relations Council, Distinguished Service Award for International Statesmanship^[65]

Selected works and publications[edit]

Scholia has a profile for Deborah L. Birx (Q24239052).

Birx DL, Redfield RR, Tosato G (April 3, 1986). "Defective Regulation of Epstein–Barr Virus Infection in Patients with Acquired Immunodeficiency Syndrome (AIDS) or AIDS-Related Disorders". New England Journal of Medicine. 314 (14): 874–879. doi:10.1056/NEJM198604033141403. PMID 3005862. Wikidata ()
Redfield RR, Birx DL, Ketter N, Tramont E, Polonis V, Davis C, Brundage JF, Smith G, Johnson S, Fowler A (June 13, 1991). "A Phase I Evaluation of the Safety and Immunogenicity of Vaccination with Recombinant gp160 in Patients with Early Human Immunodeficiency Virus Infection". New England Journal of Medicine. 324 (24): 1677–1684. doi:10.1056/NEJM199106133242401. PMID 1674589. Wikidata ()
Wolfe ND, Heneine W, Carr JK, Garcia AD, Shanmugam V, Tamoufe U, Torimiro JN, Prosser AT, Lebreton M, Mpoudi-Ngole E, McCutchan FE, Birx DL, Folks TM, Burke DS, Switzer WM (May 23, 2005). "Emergence of unique primate T-lymphotropic viruses among central African bushmeat hunters". Proceedings of the National Academy of Sciences. 102 (22): 7994–7999. Bibcode:2005PNAS..102.7994W. doi:10.1073/pnas.0501734102. PMC 1142377. PMID 15911757. Wikidata ()
Rerks-Ngarm, Supachai; Pitisuttithum, Punnee; Nitayaphan, Sorachai; Kaewkungwal, Jaranit; Chiu, Joseph; Paris, Robert; Premsri, Nakorn; Namwat, Chawetsan; de Souza, Mark; Adams, Elizabeth; Benenson, Michael; Gurunathan, Sanjay; Tartaglia, Jim; McNeil, John G.; Francis, Donald P.; Stablein, Donald; Birx, Deborah L.; Chunsuttiwat, Supamit; Khamboonruang, Chirasak; Thongcharoen, Prasert; Robb, Merlin L.; Michael, Nelson L.; Kunasol, Prayura; Kim, Jerome H. (December 3, 2009). "Vaccination with ALVAC and AIDSVAX to Prevent HIV-1 Infection in Thailand". New England Journal of Medicine. 361 (23): 2209–2220. doi:10.1056/NEJMoa0908492. PMID 19843557. Wikidata ()
Abdool Karim Q, Baxter C, Birx D (May 2017). "Prevention of HIV in Adolescent Girls and Young Women". Journal of Acquired Immune Deficiency Syndromes. 75: S17–S26. doi:10.1097/QAI.0000000000001316. hdl:10413/15136. PMID 28398993. S2CID 42044853. Wikidata ()
Raizes E, Hader S, Birx D (November 15, 2017). "The US President's Emergency Plan for AIDS Relief (PEPFAR) and HIV Drug Resistance: Mitigating Risk, Monitoring Impact". The Journal of Infectious Diseases. 216 (suppl_9): S805–S807. doi:10.1093/infdis/jix432. PMC 5853460. PMID 29206999.
Nkengasong JN, Mbopi-Keou FX, Peeling RW, Yao K, Zeh CE, Schneidman M, Gadde R, Abimiku A, Onyebujoh P, Birx D, Hader S (November 2018). "Laboratory medicine in Africa since 2008: then, now, and the future". The Lancet Infectious Diseases. 18 (11): e362–e367. doi:10.1016/S1473-3099(18)30120-8. PMID 29980383. Wikidata ()

Notes[edit]

^ Office originally separate from that of Global AIDS Coordinator until their merge into the Office of the U.S. Global AIDS Coordinator and Health Diplomacy in 2015.

References[edit]

Citations[edit]

^ Das, Pamela (November 2016). "Deborah L Birx: on a mission to end the HIV/AIDS epidemic". The Lancet. 388 (10060): 2583. doi:10.1016/S0140-6736(16)32227-9. PMID 27894655. S2CID 36199963.
^ Rushton, Mary (2015). "Six Prominent Women Scientists Making a Difference in the AIDS Fight". IAVI Report. 19 (2): 9–16. PMID 26233966.
^ "Can Deborah Birx save us from the coronavirus?". Washington Post. Retrieved April 25, 2021.
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^a ^b ^c Pence, Mike (February 27, 2020). "Vice President Pence Announces Ambassador Debbie Birx to Serve as the White House Coronavirus Response Coordinator". whitehouse.gov (Press release) – via National Archives.
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^a ^b ^c Stolberg, Sheryl Gay (March 6, 2020). "Top Coronavirus Official for U.S. Has Fought an Epidemic Before". The New York Times.
^ Mason, Jeff (March 12, 2021). "Former Trump coronavirus coordinator Birx takes job at Texas air purifier maker". Reuters. Retrieved March 28, 2021.
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^a ^b Kerry, John (April 25, 2014). "Remarks at Swearing-in Ceremony for Ambassador-at-Large and Coordinator of the USG Activities to Combat HIV/AIDS Deborah Birx". U.S. Department of State.
^ "Class News". Johns Hopkins Nursing Magazine. Johns Hopkins School of Nursing (26). July 21, 2016.
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^a ^b ^c Paul, Aparna (April 23, 2020). "From ISEF to the White House, Dr. Deborah Birx leads the country during a public health crisis". societyforscience.org. Society for Science & the Public. Retrieved April 24, 2020.
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^a ^b Gitt, Tammie (February 28, 2020). "White House names Carlisle High School grad to serve as chief adviser on coronavirus response team". The Sentinel.
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^a ^b "CHS Alum Heads Coronavirus Task Force". Coronavirus Task Force Carlisle Area School District News. Retrieved April 24, 2020.
^ "HIGHLIGHT OF ONE OF OUR OWN". casef.org. Capital Area Science and Engineering Fair. Retrieved April 24, 2020. Dr. Deborah Birx is a graduate of Carlisle High School and the Capital Area Science & Engineering Fair Senior Grand Champion of 1973.
^ "Medical Students United In Marriage". newspapers.com. The Sentinel, Carlisle, Pennsylvania Dec 1976. Retrieved October 9, 2021.
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^ "Members of the Board: United States of America: Board Member – Deborah L. Birx". The Global Fund. Retrieved March 22, 2020.
^ Birx, Deborah L. (March 6, 2014). "Written Testimony: Deborah L. Birx, MD Ambassador at Large Designate and Coordinator Designate, Department of State, United States Government Activities to Combat HIV/AIDS Globally Senate Foreign Relations Committee" (PDF). Senate Foreign Relations Committee. U.S. Senate.
^ Markey, Edward J. (March 6, 2014). "Nominations of Deborah Birx; Suzan LeVine; Maureen Cormack; and Peter Selfridge" (PDF). United States Senate, Committee on Foreign Relations.
^ Cardin, Ben (January 10, 2014). "Cardin Welcomes the Nomination of Dr. Deborah L. Birx of Maryland to be Ambassador at Large and Coordinator of United States Government Activities to Combat HIV/AIDS Globally". U.S. Senator Ben Cardin of Maryland.
^ "PN1312 — Deborah L. Birx — Department of State". Congress.gov. April 2, 2014. Retrieved April 26, 2020.
^ "Dr. Deborah Birx Sworn-In as New U.S. Global AIDS Coordinator". U.S. President’s Emergency Plan for AIDS relief (Press release). April 4, 2014. Archived from the original on March 25, 2015.
^ Birx, Deborah (April 14, 2016). "Harnessing the Data Revolution for an AIDS-Free Generation". HuffPost.
^ "Making the Dream to End HIV a Reality by Empowering Adolescent Girls and Young Women: Emerging lessons from the DREAMS partnership". Population Council. June 15, 2018.
^ "Audit of the Department of State's Coordination and Oversight of the U.S. President's Plan for Emergency Relief" (PDF). February 14, 2020.
^ Shear, Michael (February 29, 2020). "Who's on the U.S. Coronavirus Task Force: Dr. Deborah L. Birx". The New York Times.
^ Kelly, Caroline. "Pence's 'right arm' on coronavirus response has lengthy experience battling HIV epidemic". CNN. Retrieved July 19, 2020.
^ "Virus coordinator Birx is Trump's data-whisperer". AP NEWS. March 28, 2020. Retrieved July 19, 2020.
^ Baragona, Justin (April 26, 2020). "Dr. Birx Waves Off Trump's Disinfectant Comments, Says 'This Was a Musing'". The Daily Beast. Retrieved October 13, 2020.
^ Noack, Rick; Mettler, Katie; Knowles, Hannah; Armus, Teo; Berger, Miriam (March 26, 2020). "Coronavirus death toll in U.S. reaches 1,000 as number of confirmed cases passes China". The Washington Post.
^ Schwartz, Ian (March 26, 2020). "Dr. Birx: Coronavirus Data Doesn't Match The Doomsday Media Predictions". Real Clear Politics.
^ Shear, Michael D.; Weiland, Noah; Lipton, Eric; Haberman, Maggie; Sanger, David E. (July 19, 2020). "Inside Trump's Failure: The Rush to Abandon Leadership Role on the Virus - The New York Times". The New York Times. Archived from the original on July 19, 2020. Retrieved July 19, 2020.
^ "Birx On 'Stay-At-Home' Protests: 'Devastatingly Worrisome'". NPR.org. Retrieved July 19, 2020.
^ Stolberg, Sheryl Gay (July 14, 2020). "Trump Administration Strips C.D.C. of Control of Coronavirus Data". The New York Times. ISSN 0362-4331. Retrieved August 6, 2020.
^ "Who took down the CDC's coronavirus data? The agency itself". POLITICO. Retrieved August 6, 2020.
^ Carey, Benedict (August 2, 2020). "Birx Says U.S. Epidemic Is in a 'New Phase'". The New York Times. ISSN 0362-4331. Retrieved August 6, 2020.
^ Collins, Kaitlan (August 12, 2021). "Trump adds coronavirus adviser who echoes his unscientific claims". CNN. Retrieved June 12, 2021.
^ Avlon, John; Warren, Michael; Miller, Brandon (October 29, 2020). "Atlas push to 'slow the testing down' tracks with dramatic decline in one key state". CNN. Retrieved June 12, 2021.
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^a ^b Sun, Lena H.; Dawsey, Josh. "Top Trump adviser bluntly contradicts president on covid-19 threat, urging all-out response". The Washington Post. ISSN 0190-8286. Retrieved November 21, 2020.
^ Bennett, Kate; Cohen, Elizabeth (October 29, 2020). "Birx cedes White House turf to Atlas while hitting the road to spread her public health gospel". CNN. Retrieved June 12, 2021.
^ Olson, Jeremy (August 31, 2020). "Birx urges Minnesota to 'buckle down' on COVID-19 before winter". StarTribune. Retrieved June 12, 2021.
^ Bakst, Brian (August 30, 2020). "Birx makes mask pitch, voices concern over Minnesota COVID-19 trends". MPR. Retrieved June 12, 2021.
^ Read, Katy (October 24, 2020). "In Rochester, Birx expresses 'deep concerns' about COVID-19 picture in Minnesota: In Rochester, the White House's COVID-19 adviser sounded a dire alarm". StarTribune. Retrieved June 12, 2021.
^ Slavitt 2021.
^ Collins, Kaitlan (June 12, 2021). "New book suggests Birx wanted Trump to lose presidential election". CNN. Retrieved June 12, 2021.
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^a ^b Kelly, Caroline (January 24, 2021). "Birx: I always considered quitting Trump's White House Covid task force". CNN. Retrieved June 12, 2021.
^ Shear, Michael D. (July 18, 2020). "Inside the Failure: 5 Takeaways on Trump's Effort to Shift Responsibility". The New York Times. Archived from the original on July 19, 2020. Retrieved July 19, 2020.
^ Hawkins, Derek; Sonmez, Felicia (July 19, 2020). "Coronavirus updates: Trump dismisses rising cases as deaths mount". The Washington Post. Archived from the original on July 19, 2020. Retrieved July 19, 2020.
^ Weiland, Noah; Haberman, Maggie (March 27, 2020). "For Dr. Deborah Birx, Urging Calm Has Come With Heavy Criticism". The New York Times. Archived from the original on March 27, 2020. Retrieved July 19, 2020.
^ Forgey, Quint (December 22, 2020). "Deborah Birx eyeing retirement after Biden transition". POLITICO. Retrieved December 22, 2020.
^ Romo, Vanessa (December 22, 2020). "Deborah Birx, White House Coronavirus Coordinator, To Retire After Biden Transition". NPR. Retrieved June 12, 2021.
^ "Dr Deborah Birx: White House virus expert quits over holiday travel". BBC. December 23, 2020. Retrieved December 23, 2020.
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^ Choi, Matthew. "Birx says she thought of quitting the Trump administration 'always'". POLITICO. Retrieved January 23, 2021.
^ Axelrod, Tal (January 22, 2021). "Birx says she regularly considered quitting". TheHill. Retrieved January 23, 2021.
^ Williams, Jordan (March 12, 2021). "Deborah Birx to become fellow at George W. Bush Institute". TheHill. Retrieved September 24, 2021.
^ Thompson, Elizabeth (March 12, 2021). "Deborah Birx, ex-White House COVID response coordinator, joins George W. Bush Institute in Dallas". Dallas News. Retrieved September 24, 2021.
^ Quinn, Melissa; Brennan, Margaret. "Birx says there was no "full-time team" working on COVID response in Trump White House". www.cbsnews.com. Retrieved January 25, 2021.
^ "Deborah L. Birx, M.D. | Bush Center". Deborah L. Birx, M.D. | Bush Center. Retrieved September 24, 2021.
^ Bass, Emily. "Can Deborah Birx save us from the coronavirus?". Washington Post. Retrieved July 29, 2020.
^ Burgess, Phil (March 20, 2020). "Phil Burgess: Deborah Birx is the grandmother coordinating the White House response to coronavirus pandemic". Capital Gazette.
^ Walsh, S. M. (April 3, 2020). "Deborah Birx's Husband Is Former Clinton 'Advance Man' Paige Reffe". Heavy.com. Retrieved August 2, 2020.
^ "Project on Transitional Democracy - Mr. Paige E. Reffe - Secretary". www.projecttransitionaldemocracy.org. Retrieved August 2, 2020.
^ Redfield, MC, LTC Robert R. (November–December 1991). "Therapy in HIV Positive Patients Using Recombinant GP160 Vaccine". Army Research, Development & Acquisition Bulletin PB 70-91-6. HQ, U.S. Army Materiel Command. 91 (6): 36–37.
^ White, Corey (January 10, 2014). "ASLM Commends Nomination of Dr. Deborah Birx as United States Global AIDS Coordinator". African Society for Laboratory Medicine (ASLM).
^ "IRC Awardees". International Relations Council. Archived from the original on July 29, 2020. Retrieved May 8, 2020.

Slavitt, Andy (June 15, 2021). Preventable: The Inside Story of How Leadership Failures, Politics, and Selfishness Doomed the U.S. Coronavirus Response. St. Martin's Press. ISBN 978-1250770165.

Attribution[edit]

This article incorporates public domain material from websites or documents of the United States government.
This article incorporates text from this source, which is in the public domain: Deborah L. Birx, M.D.

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