One world, 2 distinct diagnoses

WASHINGTON — As then-Surgeon General Richard H. Carmona was preparing a report on world health problems, he received a detailed outline from officials at the Department of Health and Human Services. It suggested that he praise President Bush's initiative against AIDS in poor countries, and highlight American efforts to rebuild public health infrastructure in Iraq and Afghanistan. Instead, his report decried global pollution and violence against women.

Carmona's 2006 draft described condoms as an effective way to prevent AIDS, omitted U.S. efforts on public health in Iraq and Afghanistan and made only passing references to Bush. The report was subsequently pigeon-holed and never released by the health department.

The difference between the drafts, released Monday in Congress, added fuel to the controversy over whether the Bush administration has politicized science and medicine -- putting political and ideological messages ahead of scientific information.

Carmona recently testified before Congress that his report was killed because it did not conform to administration doctrine, a charge the administration disputes.

Health and Human Services spokesman Bill Hall said it was not released because a scientific review raised "strong concerns [from] multiple agencies" within the department, not because of politics.

But Rep. Henry A. Waxman (D-Los Angeles), who Monday released both the departmental outline and Carmona's report, charged that the incident reflected the determination of Bush administration officials to politicize government agencies that were supposed to be insulated from partisan influence.

"Dr. Carmona's draft thoughtfully covers a wide range of global health topics," Waxman said in a letter to HHS demanding more information on the dispute. The department's draft, he said, "ignores or glosses over serious global health problems and emphasizes the achievements and policies of the Bush administration."

Carmona declined to comment on the controversy Monday, but said he would be ready to return to Congress and testify in greater detail, if asked. Other former surgeons general who testified alongside Carmona this month said political pressure had been a problem under Republican and Democratic administrations. They urged that Congress act to make the office of the surgeon general more independent.