#eric goosby
Credit:George McCalman
“First, do no harm.”
In the 1980s, the medical establishment didn’t always heed this call when it came to HIV/AIDS.
HIV/AIDS may be manageable now, but in the early days it was a mystery and often ignored, as it primarily affected gay men and was accompanied by stigma and shame. Many doctors and medical administrators stood by as the disease took its toll. Eric Goosby was one of the pioneers who shed light and provided much-needed treatment.
The fight against HIV/AIDS has consumed Goosby’s entire career, and millions of lives have been bettered thanks to the intensity of his commitment. Goosby received his M.D. in 1978 from UCSF, completing his residency there in 1981 — the first year AIDS was clinically observed by UCLA doctor Michael Gottlieb. By the time his fellowship at UCSF ended in 1983, San Francisco was in a full-blown crisis, and Goosby was on the front lines, a member of the revolutionary Ward 86, the first dedicated AIDS clinic in the country.
Credit: UCSF
Figuring out the nature of the crisis, while trying to treat it, absorbed the doctors of Ward 86, who developed the “San Francisco Model” of care: a patient-centered collaboration with a wide network of carers, including social workers, mental health care providers, addiction specialists and community organizers. This model has become the standard of care around the world. Goosby focused on establishing partnerships with methadone maintenance clinics to help addicts obtain HIV services, as IV users were less likely to seek treatment and the black community was overrepresented among injection drug users.
Even as Goosby and Ward 86 attacked AIDS on multiple fronts, patients were slipping away. Goosby and the other doctors fell into despair during therapeutic group sessions and struggled to maintain their personal relationships. The fight was further complicated by a lack of response from the federal government, who ignored the epidemic for many years. There wasn’t funding for research, education or treatment programs for this national health crisis. In cities that weren’t using the “San Francisco Model,” those with HIV/AIDS were suffering, especially patients from marginalized communities that were being misdiagnosed and poorly served.
Dr. Eric Goosby, U.S. Global AIDS Coordinator, gives his perspective on 30 years of HIV/AIDS in the U.S. Credit: HIV.gov
Fed up with inaction, and having lost his 500th patient, Goosby moved to Washington, D.C., in 1991 to direct HIV Services at the Health and Human Services Department, spreading the approach of the San Francisco Model throughout the country. Even as he took on this important federal role, he practiced part-time in an AIDS clinic in the city’s public hospital, D.C. General. As an administrator, he brought funding and services to 25 AIDS epicenters and to all 50 states and U.S. territories, and rose up the ladder to become director of the health department’s office of HIV/AIDS policy. He later became President Clinton’s senior advisor on HIV-related issues and helped initiate a dialogue on racial disparities in HIV/AIDS that formed the basis of the Minority AIDS Initiative.
As treatment slowly began to advance in the U.S., Goosby turned his attention to the rest of the world, where poorer nations, in particular, were finding themselves devastated by the disease. After working on scaling up treatment in Rwanda, South Africa, China and Ukraine as CEO of Pangaea Global AIDS Foundation, Goosby was nominated by President Obama to serve as the U.S. global AIDS coordinator and administer the President’s Emergency Plan for AIDS Relief (Pepfar), a $48 billion program credited with cutting AIDS deaths by 10 percent in some countries.
The remarkable career of Eric Goosby has no end in sight. In addition to serving as the U.N. special envoy for tuberculosis, Goosby is a professor of medicine at UCSF. And, of course, he returned to care for patients at Ward 86, which continues to provide treatment and set standards for prevention and care around the world.
“It’s just something that is almost like breathing to me. I love practicing medicine; I love helping people in that way; I like using my mind in that way; maybe I love pushing people around; maybe I love telling people what to do. I don’t know what it is, but I cannot imagine not doctoring.”
