Randall L. Tobias

Public sector career

President George W. Bush nominated Tobias, then CEO of Eli Lilly, to be the first United States Global AIDS Coordinator on July 2, 2003. Bush chose Tobias to appease pharmaceutical companies that viewed the President's Emergency Plan for AIDS Relief (PEPFAR)'s distribution of generic medications as patent infringement. He was confirmed by the Senate on October 3, 2003, and sworn in on October 6. Tobias' decision to require Food and Drug Administration approval of generic medications before their use in PEPFAR activities was criticized as unnecessary, as the manufacturers already received approval from the World Health Organization. Under pressure from Congress, Tobias compromised by accelerating FDA approval of PEPFAR drugs.

In 2006, Tobias became the first United States Director of Foreign Assistance and concurrently served as the Administrator of the United States Agency for International Development (USAID). Tobias was confirmed by the Senate on March 29, 2006, and was sworn in on March 31.

In these positions, Tobias was responsible for overseeing all foreign assistance activities of the American government. In addition to his direct responsibilities for USAID, Tobias was charged with directing the transformation of the American approach to foreign assistance. As Director of Foreign Assistance, Tobias was responsible for providing strategic direction and guidance to all other foreign assistance programs delivered through the various agencies and entities of the U.S. Government, including the Millennium Challenge Corporation and the Office of the U.S. Global AIDS Coordinator. He reported directly to Secretary of State Condoleezza Rice and held the rank of Deputy Secretary of State.

Tobias resigned in disgrace on April 27, 2007, after being linked to the D.C. Madam scandal of Deborah Jeane Palfrey. He was a member of the board of directors of the Overseas Private Investment Corporation. This corporation was dissolved in 2019.

On April 26, 2007, Tobias was questioned by Federal investigators, regarding any services he received from the escort service owned by Deborah Jeane Palfrey, who has been charged with prostitution-related racketeering. When reached by ABC News on April 26, Tobias said he had several times called the "Pamela Martin and Associates" escort service "to have gals come over to the condo to give me a massage." Tobias, who is married, said there had been "no sex," and that recently he had been using another service "with Central Americans" to provide his "massages."

The next day, April 27, 2007, Tobias resigned from his U. S. State Department position as Director of US Foreign Assistance and as Administrator of the United States Agency for International Development (USAID). A State Department press release said only he was leaving for "personal reasons."

Denouncements of prostitution

As President Bush's AIDS Coordinator, Tobias was responsible for setting policy detailing which countries would receive monies from various US agencies, how much, and what the rules governing assignment of those funds would be. As AIDS Coordinator, he discussed the rules in an interview with PBS' Frontline where he detailed a legal requirement that recipients of U.S. aid denounce prostitution:

The Congress I think very appropriately has put into the legislation that created this program that organizations, in order to receive money, need to have a policy opposed to prostitution and sex trafficking. I don't think it's too difficult for people to be opposed to prostitution and sex trafficking, which are in fact two contributing causes to the spread of HIV/AIDS. I think when organizations initially became aware of that requirement, some organizations were concerned about what the implications of that might be, but we implemented that in the first year with non-U.S. organizations. We're now implementing that requirement with U.S. organizations. And so far, I really know of no problems that we've had on the ground.

"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, Washington, D.C. The Bush administration's 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.