Ex-AIDS chief in escort flap called hypocritical

WASHINGTON -- Randall L. Tobias , the Bush administration official responsible for foreign assistance who resigned late Friday because of his use of an escort service allegedly involved in prostitution, was ridiculed as a hypocrite yesterday because he supported US policies that forced overseas organizations not to help prostitutes.

Others, who called Tobias a strong manager, said that he was so integral to US foreign aid that the Bush administration may now retreat from some initiatives rather than draw attention to the circumstances of his departure.

Tobias, who is 65 and married, told ABC News late last week that he had used the escort service "to have gals come over to the condo to give me a massage" and there had been "no sex" involved. He also told the network that he had been using another service with Central American women.

"I think it is somewhat ironic and hypocritical that he would patronize an escort service while he was denying funding to organizations who want to help prostitutes, and supporting a policy that obviously forbids fraternizing with prostitutes," said Jodi Jacobson , executive director for the Center for Health and Gender Equity, an advocacy group based outside Washington, D.C.

The Bush administration's policy requires that groups receiving US money "have a policy explicitly opposing prostitution and sex trafficking." That policy, said Jacobson and others, has led to the closure of numerous programs that had been teaching job skills to sex workers, forcing many prostitutes out of brothels and into the street.

In political and development circles around Washington and world capitals, Tobias's fall took on great importance because of his central role in first leading the US administration's ambitious global AIDS program. More recently, he oversaw a historic reorganization of American foreign assistance.

Several activists, even those who opposed Tobias on many issues, worried yesterday that his hasty retreat into private life could result in the Bush administration paying less attention to foreign aid in its last 20 months. His resignation also comes at a time when World Bank President Paul D. Wolfowitz is in danger of losing his job over questions raised by his role in getting a new job and hefty pay raise for his companion. Wolfowitz is scheduled to meet with a special panel considering his fate tomorrow.

Such a period of uncertainty in the development world, activists say, could influence discussions among leaders of the largest industrial nations when they gather in Germany in June. They are expected to debate whether to spend billions more in poor countries.

Prior to government service, Tobias was one of the country's biggest names in the corporate world, running giant pharmaceutical company Eli Lilly and Co. Working Mother magazine named him CEO of the Year in 1996. Business Week called him one of nation's top 25 managers in 1997. His book, "Put the Moose on the Table," which advocates addressing difficult issues in a forthright manner, became a best seller. And in retirement, he started a foundation that supported educational programs in Indiana, where he has kept his home.

He also was a top Republican fund-raiser and staunch supporter of President Bush. Bush persuaded Tobias to take charge of his five-year global AIDS initiative known as PEPFAR, or the President's Emergency Plan for AIDS Relief, which is now on track to spend $18 billion. During his tenure, AIDS treatment, care, and prevention programs were started, but there were also bruising battles with activists over policies relating to generic drugs and abstinence-only initiatives, as well as charges of favoritism in giving grants to evangelical Christian groups with little experience in Africa.

As head of PEPFAR, Tobias traveled frequently to Africa, holding meetings with a broad range of people fighting AIDS, including a barefoot traditional healer in South Africa so enamored of Tobias that she gave him a live chicken -- which he, in turn, presented to an AIDS patient -- and a drag queen who told the AIDS czar intimate details of his life.

"We have to listen to them," he said in a 2004 interview after meeting the traditional healer, Makhosi Nokusho Bhengu , then 72. "We're not here implementing our strategy, but implementing their strategy."

Less than two years ago, Bush asked Tobias to overhaul the way in which overseas aid is given. Tobias, following the PEPFAR model to a degree, supported aid to countries with records of good governance and that could produce measurable results.

The US foreign aid bureaucracy is "going to be rudderless for a while because they relied on him so much," said Jim Yong Kim , a professor specializing in global health at Brigham and Women's Hospital and Harvard Medical School.

He called Tobias "a really good manager. He knew how to bring order to a chaotic situation. He really knew how to make decisions. PEPFAR is by far one of the best things that George Bush ever did in his presidency, and Tobias had a lot to do with it."

But Kim, who formerly was director of HIV/AIDS programs at the World Health Organization, said that some of Tobias's policy decisions also had negative impacts on the fight against AIDS. "I completely disagreed with their all-out attacks against making generic drugs more available" by refusing to use the WHO's system for testing the efficacy of medicines, he said.

Michael Weinstein , president of AIDS Healthcare Foundation , a Los Angeles-based group with extensive experience in treating AIDS patients, said that Tobias's policy to test all generic medicine through the US Food and Drug Administration "meant that fewer people received drugs."

But Weinstein did not want to criticize Tobias for using an escort service. "The bottom line for me is whatever indiscretion he was involved in does not invalidate his record," he said. "It's really not very relevant to the job he did, and if we want to sacrifice more and more people on the altar of their personal foibles then we are not going to have people of his stature wanting these jobs."

John Donnelly can be reached at donnelly@globe.com