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Biden rounds out team to take on HIV/AIDS domestically, globally

Experts say ‘too soon’ to assess domestic efforts

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Biden names a global AIDS coordinator and new PACHA members

With the goal of beating HIV by 2025 domestically and a pledge for a renewed effort to fight the disease globally, President Biden has put in place officials charged with making that happen.

The White House kicked off the week with the announcement that John Nkengasong, who has served as a top official on global health at the Centers for Disease Control, would be nominated as ambassador-at-large and coordinator of U.S. government activities to combat HIV/AIDS globally at the State Department.

Meanwhile, leadership within the Presidential Advisory Council on HIV/AIDS, otherwise known as PACHA, was restructured in August as the Biden administration has continued the Ending the HIV Epidemic plan health officials started in the Trump administration.

Carl Schmid, who served as co-chair of PACHA during the Trump years, no longer holds that position, and has been replaced by Marlene McNeese, a woman of color and deputy assistant director of the Houston Health Department. John Wiesman, former secretary of health for Washington State, will continue to serve as co-chair.

McNeese is among eight new members of PACHA. The others are:

  • Guillermo Chacón, president of the Latino Commission on AIDS;
  • Tori Cooper, director of community engagement for the Transgender Justice Initiative at the Human Rights Campaign;
  • Raniyah Copeland, CEO of the Black AIDS Institute;
  • Leo Moore, medical director for clinic services at the Los Angeles County Department of Public Health;
  • Kayla Quimbley, national youth HIV and AIDS Awareness Day ambassador for Advocates for Youth;
  • Adrian Shanker, founder and executive director of Bradbury-Sullivan LGBT Community Center; and
  • Darrell Wheeler, senior vice president for academic affairs at Iona College in New Rochelle, N.Y.

The changes underscore the new approach to HIV/AIDS Biden promised during his presidential campaign. Among them is beating HIV/AIDS domestically by 2025, which is five years earlier than the plan under the Ending the HIV Epidemic initiative that began in the Trump administration. Whether or not Biden will meet that ambitious goal remains to be seen.

Winnie Byanyima, executive director of UNAIDS, hailed the nomination of Nkengasong to the global AIDS position upon news of the announcement.

“John Nkengasong’s vast experience in combatting HIV, combined with his position as Africa’s leading disease expert fighting Ebola, COVID-19 and more, position him extremely well to guide the United States’ global contribution towards ending the AIDS pandemic,” Byanyima said. “Today, the HIV and COVID-19 pandemics are colliding in communities throughout the world, and the threat of a resurgent AIDS pandemic is very real. We need the kind of bold thinking and commitment he has brought throughout his career.”

While the global AIDS appointment will have a role in international programs, such as PEPFAR and U.S. participation in the Global Fund to Fight AIDS, Tuberculosis & Malaria, the PACHA appointments will focus on both domestic and global perspectives.

Schmid, executive director of the HIV+Hepatitis Policy Institute, said despite the change in leadership he will maintain his role as head of the subcommittee on the Ending the HIV Epidemic initiative.

“It’s good,” Schmid said.”They appointed a lot of African-American community, Latino community [members] and they said they’ll rotate co-chairs,” Schmid said. “I think it’s good that they put on new blood, and new leadership.”

Schmid has been a vocal skeptic about Biden being able to meet his goal to beat HIV by 2025 — as opposed to the 2030 target set by the previous administration — but said the realignment in PACHA was “not at all” related to that.

“I think I was replaced because the Biden administration wanted the leadership of PACHA to be more representative of the current epidemic in the United States,” Schmid said.

Schmid, however, refused to back down from his prediction that Biden won’t be able to make his 2025 goal a reality.

“I think you will find wide agreement within the HIV community that it is not feasible to end HIV by 2025,” Schmid said. “There is just too much work to do and change to happen.”

The new appointments will add to the cadre of Biden appointees engaged on HIV/AIDS, including Harold Phillips, who was appointed in June to lead the White House Office of National AIDS Policy after that position remained vacant for the entirety of the Trump administration.

‘Too early’ to gauge effort to beat HIV domestically

The focus of the appointees on the domestic front will be the Ending the HIV Epidemic initiative, a plan heavily focused on PrEP as a means of preventing HIV in an effort to reduce new incidents of infections by 90 percent within 10 years. The program was launched in 2019.

Although Congress has appropriated money for the initiative, and just last week, the Department of Health & Human Services distributed $48 million to HRSA centers as part of the effort, experts say not enough data is available to tell to whether or not the program has been effective.

Jennifer Kates, senior vice president and director of global health & HIV policy at Kaiser Family Foundation, said data isn’t yet available on whether new incidents of HIV are reduced because the latest data is from fiscal year 2019.

“From the perspective of the timeline of the goals of the initiative, it’s too early, we wouldn’t know that anyway, but just even given the context and what’s happened since it started, I just don’t know how you’d evaluate it,” Kates said. “What I do believe is important though, is the idea of dedicated new funding. It was the first new funding provided to HIV for years that’s been channeled to local jurisdictions [and] has the potential to catalyze new and better responses, but we don’t know yet that’s happened.”

The coronavirus pandemic, which has been the top priority for health officials around the world, is also obfuscating any potential assessment of the Ending the HIV Epidemic initiative.

Daniel Bruner, senior director of policy at the D.C.-based Whitman-Walker Institute, said the coronavirus has “dramatically impacted medical care,” including HIV/AIDS efforts.

“The pandemic has also necessitated substantial shifts in federal, state, and local resources into COVID prevention, diagnosis and treatment,” Bruner said. “Therefore, it is premature to draw any conclusions about the EHE initiative’s effectiveness. The federal government has emphasized its continuing commitment to the EHE initiative, and Whitman-Walker also remains committed to that work.”

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Netherlands

Amsterdam Pride Canal Parade draws hundreds of thousands

Gay Dutch Prime Minister Rob Jetten among participants

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A scene from the 2026 Amsterdam Pride Canal Parade. (Washington Blade photo by Michael Key)

Editor’s note: International News Editor Michael K. Lavers and Photo Editor Michael Key are on assignment in the Netherlands through Aug. 10.

AMSTERDAM — Hundreds of thousands of people lined Amsterdam’s canals on Saturday for the city’s annual Amsterdam Pride Canal Parade.

Dutch Prime Minister Rob Jetten, who is openly gay, is among those who participated in the parade that featured more than 80 boats. Participants held signs and posters that, among other things, read “proud to be intersex” and “lesbians love you and a free Palestine.”

The Washington Blade saw at least two attendees holding fans that read “fuck Trump.” One of the boats also compared President Donald Trump and Russian President Vladimir Putin as “the kissing couple.”

(Washington Blade photo by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

(Washington Blade video by Michael K. Lavers)

The parade took place a week after a terrorist attack at Berlin’s Christopher Street Day left one person dead and more than two dozen others injured.

It passed the Homomonument, a memorial to gays and lesbians who have suffered persecution. The Homomonument has been transformed into a makeshift memorial to the victims of the July 25 terrorist attack in the German capital.

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The Canal Parade took place during World Pride, which will end in Amsterdam on Aug. 9.

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European Union

Poland’s top court rejects recognition of same-sex marriages from other EU countries

Ruling sets up potential clash with bloc

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(Bigstock photo)

Poland’s top court this week rejected the recognition of same-sex marriages legally performed in other EU countries.

The EU Court of Justice in Luxembourg last November ruled in favor of a same-sex couple who challenged Poland’s refusal to recognize their German marriage. Poland’s Supreme Administrative Court in March reaffirmed the decision.

The couple, who lives in Poland, brought their case to Polish courts in 2019. The Supreme Administrative Court referred it to the EU Court of Justice.

The Polish government in May announced it will recognize same-sex marriages legally performed in other EU countries. Polish President Karol Nawrocki on July 17 vetoed bills that would have extended rights to same-sex couples.

The Constitutional Tribunal ruling, which it issued on July 28, was unanimous and final. It also sets up a potential clash between it and the EU Court of Justice.

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Taiwan

Taiwan’s government has failed to update process to change gender markers on ID documents

Interior Ministry’s 2008 directive remains in place

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(Photo by bRollGO/Bigstock)

More than four years after Taiwan began formally studying legislation to overhaul its legal gender recognition system, and despite repeated recommendations from international human rights experts, the government has yet to introduce a bill that would replace decades-old administrative rules governing how transgender people can change the gender marker on official documents.

On May 15, an independent international review committee examining Taiwan’s implementation of the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights urged the government to enact legislation governing legal gender recognition. The committee said Taiwan’s continued reliance on an administrative order, despite a 2023 Supreme Administrative Court ruling that mandatory gender-affirming surgery violates constitutional rights, has created legal uncertainty for transgender people, administrative authorities and judges.

In Taiwan, legal gender recognition has long been governed by a 2008 Interior Ministry administrative directive rather than legislation. 

Under the directive, applicants seeking to change the gender marker on their national identification documents are generally required to provide diagnoses of gender dysphoria from two psychiatrists and proof that they have undergone gender-affirming surgery. For trans men, this typically involves the removal of the breasts, uterus, and ovaries, while trans women generally must undergo the removal of the penis and testicles. Because these requirements are established through an administrative directive rather than a law enacted by the legislature, trans rights activists and human rights organizations have argued they violate human rights.

Although Taiwanese courts have increasingly allowed trans people to change the gender marker on their official documents without undergoing gender-affirming surgery, the Interior Ministry’s 2008 directive requiring surgery remains in force. As a result, Taiwan’s administrative rules and judicial decisions are no longer fully aligned.

In a landmark ruling in May 2024, the Taipei High Administrative Court ordered a household registration office to approve a trans man’s application to change the gender marker on his household registration without requiring gender-affirming surgery. The court held that the Interior Ministry’s 2008 administrative directive, which requires applicants to submit proof of surgery, cannot be treated as an absolute prerequisite for legal gender recognition. Instead, it found that the applicant had provided sufficient medical evidence of a stable and long-standing gender identity and that denying the application solely because he had not undergone surgery was unlawful.

The Executive Yuan began work on legislation in April 2020, when it decided to commission an academic study examining international legal gender recognition systems rather than immediately drafting a law. 

The government subsequently commissioned Shih Hsin University to prepare a report reviewing foreign legal models and developing legislative recommendations, including a bill. Since 2022, the Executive Yuan has held a series of inter-agency meetings involving multiple ministries to consider the study’s recommendations and legislation governing legal gender recognition, though no bill has yet been enacted.

In September 2023, Taiwan’s Supreme Administrative Court set aside a lower court ruling that had upheld the Interior Ministry’s refusal to change a trans person’s legal gender without proof of surgery and ordered the case to be reheard. 

The court held that the ministry’s 2008 administrative directive requiring surgery could not be treated as the controlling legal standard because it lacked a clear statutory basis and implicated constitutional protections, including bodily autonomy and personality rights. Rather than treating surgery as an automatic prerequisite, the court instructed the lower court to determine whether the applicant had established a stable gender identity based on the evidence presented.

“From our perspective, the primary goal should be lowering the barriers to legal gender recognition, particularly by abolishing the mandatory surgery requirement,” the Taiwan Tongzhi (LGBTQ+) Hotline Association, a nonprofit LGBTQ advocacy and support organization founded in 1998, said in an email to the Washington Blade.

The Taiwan Tongzhi (LGBTQ+) Hotline Association said several factors have stalled progress toward comprehensive legislation. 

The organization told the Blade the complexity of the issue and the lack of constructive dialogue are among the primary obstacles. It said legal gender recognition requires extensive discussion, with views differing even within the trans community itself. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that opinions also vary widely within the legislature and across Taiwanese society, while effective channels for dialogue remain lacking.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also attributed the lack of progress to what it described as a lack of political will and an over reliance on “social consensus.” 

According to the organization, the executive branch lacks the political momentum to advance legal gender recognition reforms. The Taiwan Tongzhi (LGBTQ+) Hotline Association said the Interior Ministry and other relevant agencies have often adopted a passive approach in the face of opposition from conservative groups, delaying progress by arguing that there is no social consensus or that further discussion is needed.

The Taiwan Tongzhi (LGBTQ+) Hotline Association also said progress has been hindered by what it described as a backlash following the legalization of same-sex marriage. According to the organization, groups opposed to gender equality and trans rights, including some conservative religious and anti-trans organizations, shifted their focus to trans issues after marriage equality became law. The Taiwan Tongzhi (LGBTQ+) Hotline Association said these groups have promoted fear-based narratives, including concerns about safety in public restrooms, leading many politicians to view trans rights as a politically risky issue and reducing momentum for legislative action.

“The existing system makes changing one’s legal gender marker extremely difficult. Forced surgical removal of reproductive organs imposes a heavy financial burden since it must be paid out-of-pocket, and not every trans person can afford, desires, or is medically advised to undergo organ removal,” the Taiwan Tongzhi (LGBTQ+) Hotline Association said. “Additionally, requiring psychiatric evaluations is problematic because specialized medical resources are scarce and concentrated in major cities. These obstacles severely impact transgender individuals in their daily lives.”

The Taiwan Tongzhi (LGBTQ+) Hotline Association said the continued reliance on an administrative directive rather than legislation has created systemic uncertainty for trans people. The organization said the absence of a statutory framework allows executive agencies to alter requirements without legislative oversight, leaving trans people uncertain whether future policies will become more restrictive or more permissive. The Taiwan Tongzhi (LGBTQ+) Hotline Association added that while several trans people have secured favorable court rulings since 2023, those decisions apply only to the individual cases before the courts and do not guarantee similar outcomes for others. The group also said pursuing litigation requires significant time, financial resources, and emotional investment, making it an inaccessible path for many trans people seeking legal recognition.

The Executive Yuan and the Interior Ministry did not respond to the Blade’s requests for comment.

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