Succumbing to political pressure, the Centers for Disease Control and Prevention (CDC) censored critical public health perspectives on abstinence-only-until-marriage programs at the 2006 National STD Prevention Conference. After Representative Mark Souder (R-IN), chair of the House Subcommittee on Drug Policy raised questions about the panel’s “balance,” the CDC changed the title and replaced two key speakers. Public health experts and policymakers alike have expressed shock and deep concern about the potential ramifications of such unprecedented political intervention in a scientific forum.

Bruce Trigg, head of the STD programs at the New Mexico Department of Health, organized the original panel, titled “Are Abstinence-Only-Until-Marriage Programs a Threat to Public Health?” Panelists included John Santelli, a professor at the Mailman School of Public Health at Columbia University, William Smith, vice president for public policy at SIECUS, and Maryjo Oster, a Pennsylvania State University graduate student. Prior to being accepted to present at the conference, each panelist’s presentation went through a rigorous peer reviewed process. Their presentations were set to review the latest research on the content and impact of abstinence-only-until-marriage programs, which receive close to $200 million in federal funding annually.

On April 24 th, two weeks before the scheduled start of the government-sponsored conference, a staff person in Souder’s office sent an email to the Assistant Secretary for Legislation at the Department of Health and Human Services (HHS) asking whether the CDC was “clear about the controversial nature of this session and its obvious anti-abstinence objective.” The email message asked for a shift in the focus of the panel.1 This email led to a series of communications from HHS, which overseas abstinence-only-until-marriage program grants and implementation, to the CDC, the main organizer of the conference, and internally among CDC officials. By the next day, CDC officials, including several officials in the office of CDC Director Julie Gerberding, were discussing major changes to the session. One official wrote, “we can either drop the symposium altogether or modify it to provide a more balanced perspective.”2 Further emails confirm that HHS committed to changing the session within two days of the initial email from Souder’s office.

“Just the title alone was enough to cause us concern,” said Martin Green, Souder’s spokesman.3 Souder was particularly concerned because Smith was invited to speak about a report produced by Representative Henry Waxman (D-CA) that is critical of abstinence-only-until-marriage programs. Oster was scheduled to speak about abstinence-only-until-marriage programs ties to rising STD rates. “We wanted to see some balance on this panel,” Green said.4 In response, the CDC changed the name of the panel the week before the conference to “Public Health Strategies of Abstinence Programs for Youth” and removed presenters Smith and Oster.5

Two staunch proponents of abstinence-only-until-marriage programs, Eric Walsh and Patricia Sulak, took their place. Walsh is a family physician affiliated with Loma Linda University, a Seventh-day Adventist institution in California. His approach to public health is explicitly ideological. According to an online bio, “Dr. Walsh seeks to serve the Lord through medical missions and the preaching of the Gospel in all the world.”6 Sulak, an obstetrician-gynecologist at Scott & White Memorial Hospital in Texas, is the founder of “Worth the Wait,” an abstinence-only-until-marriage program noteworthy for its negative messages about condoms and stereotypical statements about gender differences.7

These abrupt and drastic changes were insufficient for Souder. On April 26 th, Souder’s staff again wrote to the Office of HHS Assistant Secretary of Legislation saying:

While “restructuring” the session to “balance” it out is positive in and of itself, the program as it is has already been circulated. Maybe “restructuring” is inadequate in light of the hostile “advertising” against abstinence that has already been done. Can the session be postponed or replaced entirely?8

The CDC, however, decided not to cancel the panel entirely and stuck with replacing two speakers and changing the title of the session.

Public health experts and scientists condemned these changes as political interference. Neither of the new speakers nor their presentations went through the strict peer-review process that vetted the original panel members. In addition, HHS paid for both new panelists to attend the conference, despite the fact that other speakers were told by organizers that they had to pay their own way.9

Jonathan Zenilman, president of the American Sexually Transmitted Diseases Association, a co-sponsor of the conference, said he was “surprised and astounded” by the outcome.10 Zenilman said of the new speakers, “at the CDC, they’re beside themselves. These people aren’t scientists; they haven’t written anything. The only reason they’re here is because of political pressure from the administration.”11

Trigg, the original organizer of the panel, condemned the decision as political meddling in the scientific process. “It is unprecedented that this type of interference takes places at a scientific meeting,” Trigg said. He stated that the original panel was not designed to be a balanced overview but to present the public health concerns about abstinence-only-until-marriage programs and rising STD rates. “I have nothing to fear from a balanced program. They would have been welcome to submit abstracts for review and consideration. The claim is this is about a public health program when it’s really about ideology and religion,” Trigg said.12

The morning the conference was scheduled to begin, Representative Henry Waxman (D-CA) sent a letter to HHS Secretary Michael Leavitt asking why HHS and the CDC censored a conference session critical of abstinence-only-until-marriage programs in response to political pressure and whether the department allowed a member of Congress to influence a change in the panel participating at the conference. “In effect, it appears that presentations at a public health conference were censored because they criticized abstinence-only education,” Waxman wrote in the letter. “This attempt at thought control should have no place in our government.”13

Waxman requested copies of all communications between HHS and CDC regarding the changes. He concluded his letter by stating that, “public health conferences provide a crucial forum for scientific experts to present data, ponder unanswered questions, and enrich their own understanding of the field. Key to such exchange is the presence of a review process that applies objective criteria to submitted proposals. ‘Political correctness,’ whether from the right or the left, should not displace the scientific review process.”14

In addition, Representative Tammy Baldwin (D-WI), along with 38 other members of the House of Representatives, sent HHS Secretary Leavitt a letter expressing their outrage over the “politically motivated, last-minute changes” made to the panel. The letter chastised the CDC’s actions saying that “playing politics with our nation’s public health is unacceptable” and that “our nation’s public health will suffer as a result.”

In response to the outcry, Mark Wheat, chief counsel for the drug policy subcommittee that oversees the CDC, of which Souder is chair said, “they’re upset because we rained on their little party,” adding, “they don’t like to have their orthodoxy questioned.”15

The Friday after the panel occurred, CDC spokesperson Tom Skinner said the agency will investigate the original formation of the panel. Skinner stated that changes in the panel were “just an effort to bring more balance” to the forum. However, Oster explained that she received an email on April 26 th from a CDC staff member saying that the panel was being changed “due to political pressures from above.”16 Trigg added, “this is a level of interference in the public health community that I don’t think we’ve seen before.”17 Smith said he was “very disappointed” in the outcome. “It was shocking to me,” Smith said, adding, “what does this say about the ability of politicians to influence what is going on in public health?”

References

1. Dawn Fallik, “Abstinence debate roils a talk on STDs,” Philadelphia Inquirer, 6 May 2006, accessed 16 May 2006, <http://www.philly.com/mld/inquirer/living/health/14513820.htm>.
2. Letter from Representative Henry Waxman to Department of Health and Human Services Secretary Michael Leavitt ( May 9, 2006 ).
3. Rob Stein, “Health Experts Criticize Changes in STD Panel,” Washington Post, 9 May 2006, accessed 16 May 2006, <http://www.washingtonpost.com/wp-dyn/content/article/2006/05/08/AR2006050801445.html>.
4. Ibid.
5. Amanda Schaffer, “Pro-abstinence Politics meddles with a CDC conference,” Slate, 5 May 2006, accessed 31 May 2006, <http://www.slate.com/id/2141183/?nav=tap3>.
6. Ibid.
7. Please see SIECUS’ review of Worth the Wait for more information, http://www.communityactionkit.org/reviews/WorthTheWaitSummary.html.
8. Fallik, “Abstinence debate roils a talk on STDs.”
9. Ibid
10. Ibid.
11. Stein.
12. Ibid.
13. Letter from Representative Henry Waxman to Department of Health and Human Services Secretary Michael Leavitt ( May 9, 2006 ).
14. Ibid.
15. Dawn Fallik, “STD panel’s change stirs questions,” Philadelphia Inquirer, 11 May 2006, accessed 16 May 2006, <http://www.philly.com/mld/inquirer/14549305.htm>.
16. “CDC to Investigate How Panel on Conference Panel on STIs, Abstinence Education was Formed, Official Says,” KaiserNetwork Daily Reports, 15 May 2006, accessed 16 May 2006, <http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=37248>.
17. Jackie Jadrnak, “N.M. Doctor Says Feds Tampered with Reds Tampered with Sex Ed Panel,” 12 May 2006, accessed 16 May 2006, <http://www.abqjournal.com/news/metro/459627metro05-12-06.htm>.