STREAMING NOW: Watch Now

Pence's history managing HIV crisis in Indiana under scrutiny now that he's overseeing coronavirus

When President Donald Trump appointed Vice President Mike Pence in charge of the US government's response to the novel coronavirus on Wednesday, he said the former Indiana governor had "a certain talent for this." Here's a look at what he's done in Indiana.

Posted: Feb 27, 2020 1:33 PM

(CNN) -- When President Donald Trump appointed Vice President Mike Pence in charge of the US government's response to the novel coronavirus on Wednesday, he said the former Indiana governor had "a certain talent for this."

Pence indeed has executive experience during a public health emergency: he was governor from 2013 to 2017, when an HIV outbreak struck parts of his state. But his response to that crisis -- one different in several important ways from coronavirus -- is again under scrutiny as he works to coordinate the US effort to protect against worldwide calamity that is still unfolding.

The Indiana emergency peaked during Pence's governorship, when public health officials noticed a cluster of HIV and hepatitis C in rural Indiana around November 2014. It was the largest outbreak of the virus in the state's history, NPR reported at the time.

Free HIV testing had not been available in the community since a local Planned Parenthood clinic closed in 2013, and the virus had quickly spread among people in Scott County who were reusing needles to inject a prescription opioid called Opana. In 2017, at the US Food and Drug Administration's request, pharmaceuticals company Endo International took the powerful opioid off the market because it was widely abused.

The infections had reached 126 cases in a relatively small geographical area around January 2015, but it took until March of that year for Pence to declare a public health emergency.

"I am confident that together we will stop this HIV outbreak in its tracks," Pence said at the time.

One study that ran in The Lancet medical journal in 2018 found that if Pence had acted sooner, a quicker public health response could have substantially reduced the total number of HIV infections. What was needed, experts said, was a needle exchange program, which is controversial but has been strongly recommended by the Centers for Disease Control and Prevention as an impactful way of preventing transmission of disease among drug users. At the time of the Indiana outbreak, it was illegal under state law and opposed by Pence.

The then-governor eventually approved a short-term needle exchange program, the Indianapolis Star reported at the time, but only did so reluctantly.

"I do not enter into this lightly," he said, the Star reported. "In response to a public health emergency, I'm prepared to make an exception to my long-standing opposition to needle exchange programs."

The program was effective. Some 277 people enrolled in the program and more than 90,000 syringes were distributed and returned between April and October 2015, a study in the New England Journal of Medicine found, and the number of new HIV infections decreased.

At Wednesday's news conference announcing Pence's appointment, Trump said Indiana has established "great health care" in the Hoosier State. But during Pence's tenure as governor, Indiana only moved up the nationwide ranks slightly, remaining near the bottom of America's Health Rankings, a survey of how states manage health. In 2017, US News and World Report ranked Indiana 41 among states for health care.

Meanwhile, substance-use treatment in rural Indiana remained "woefully inadequate," according to a perspective piece written by public health experts for the New England Journal of Medicine that called the state's approach to the outbreak a "cautionary tale." The state's "suboptimal coverage" of HIV and hepatitis C testing also delayed people getting treatment and that allowed for more people to become infected, the medical journal piece said.

And the public health spending in Indiana for 2017 ranked near the bottom of states, according to the Trust for America's Health.

Reached for comment by CNN, Pence's office pointed to an October 2019 op-ed written by Joey Fox, a former legislative director for Indiana's state health department, who defended Pence's response. In particular, Fox noted that needle exchange programs were illegal in Indiana before Pence took office and that it took time to effectively implement the program when Pence made it available.

"Acting as if the community refused to use a proven public health tool is disingenuous at best. The tool was illegal. Law had to be changed. The Governor intervened by executive order. The legislature passed a bill changing the law on the final night of the session, and Governor Pence signed it shortly thereafter," Fox wrote.

After this story published, Surgeon General Jerome Adams, who served as Indiana's state health commissioner during the HIV crisis, said efforts taken by himself and Pence served as an example to other states in handling an HIV outbreak.

"Working together, we helped address the outbreak by implementing comprehensive syringe services programs (SSPs) that helped change the scope of the unprecedented crisis," Adams said. "As a result, our efforts became a model for how other states and localities respond to similar crises -- states like Kentucky, for example, went from zero to more than 70 comprehensive SSPs, to prevent future outbreaks and help people in need of care."

The vice president is scheduled to discuss coronavirus in an appearance with Sean Hannity on Fox News Thursday night.

Some Democrats, including House Speaker Nancy Pelosi, have pointed to Pence's record in Indiana to criticize Trump's decision to put him in charge of the government response.

At a CNN town hall on Wednesday night, Massachusetts Sen. Elizabeth Warren said Pence was "actively disqualified" from managing the response.

"Do keep in mind that this vice president has dealt with a public health emergency before, in Indiana. And what was his approach? It was to put politics over science and let a serious virus expand in his state and cost people lives. He is not the person who should be in charge," she said.

This story has been updated to include a response from Adams.

The-CNN-Wire
™ & © 2020 Cable News Network, Inc., a WarnerMedia Company. All rights reserved.

Terre Haute
Clear
69° wxIcon
Hi: 81° Lo: 69°
Feels Like: 69°
Robinson
Clear
67° wxIcon
Hi: 80° Lo: 69°
Feels Like: 67°
Indianapolis
Partly Cloudy
71° wxIcon
Hi: 83° Lo: 68°
Feels Like: 71°
Rockville
Partly Cloudy
66° wxIcon
Hi: 80° Lo: 67°
Feels Like: 66°
Casey
Clear
66° wxIcon
Hi: 80° Lo: 68°
Feels Like: 66°
Brazil
Clear
69° wxIcon
Hi: 81° Lo: 67°
Feels Like: 69°
Marshall
Clear
69° wxIcon
Hi: 80° Lo: 68°
Feels Like: 69°
A Calm Overnight
WTHI Planner
WTHI Temps
WTHI Radar

WTHI Events

 

Illinois Coronavirus Cases

(Widget updates once daily at 7 p.m. CT)

Cases: 1417263

Reported Deaths: 25865
CountyCasesDeaths
Cook56345210564
DuPage938521321
Will782101042
Lake692581028
Kane60143816
Winnebago34763524
Madison32544534
St. Clair30167526
McHenry29631299
Peoria23747347
Champaign21668159
Sangamon19714245
McLean18902194
Tazewell17530308
Rock Island15406329
Kankakee14758224
Kendall13521100
LaSalle12975254
Macon11202215
DeKalb10295122
Vermilion10272154
Adams9676129
Williamson8203138
Whiteside7254174
Boone694780
Ogle630084
Grundy606279
Clinton592893
Coles5882101
Knox5738157
Jackson547765
Henry516870
Macoupin499590
Livingston494694
Woodford493183
Franklin490279
Stephenson488886
Effingham483674
Marion4804118
Jefferson4679123
Monroe452594
Randolph433287
Lee424154
Morgan414593
Fulton411059
Logan408366
Christian395575
Bureau386487
Montgomery385874
Iroquois330368
Perry329662
Fayette327056
McDonough308151
Jersey279952
Saline272957
Douglas264736
Union250642
Lawrence245327
Shelby236938
Crawford220126
Bond213824
Cass211127
Carroll205337
Pike202753
Ford195250
Hancock194632
Clark191234
Wayne190453
Warren186750
Jo Daviess183624
Richland182440
White181826
Edgar180342
Washington169525
Moultrie168628
Mason164647
De Witt161529
Piatt156714
Johnson155916
Clay155543
Greene154834
Mercer152434
Wabash149412
Massac144641
Cumberland131119
Menard128712
Jasper117018
Marshall110819
Hamilton90616
Schuyler8157
Brown8136
Pulaski7477
Stark66825
Edwards63612
Calhoun5432
Henderson53414
Gallatin5144
Scott5091
Putnam4943
Alexander49211
Hardin39612
Pope3404
Unassigned592432
Out of IL20

Indiana Coronavirus Cases

(Widget updates once daily at 8 p.m. ET)

Cases: 769875

Reported Deaths: 13999
CountyCasesDeaths
Marion1057621807
Lake570271031
Allen43112700
Hamilton37395426
St. Joseph37377568
Elkhart29801471
Tippecanoe23544231
Vanderburgh23269405
Porter19593327
Johnson18880394
Hendricks18129323
Clark13595198
Madison13590347
Vigo12890256
Monroe12598178
LaPorte12585225
Delaware11170198
Howard10724237
Kosciusko9804124
Hancock8778150
Bartholomew8286157
Warrick8094157
Floyd8063182
Grant7387181
Wayne7244201
Boone7221105
Morgan6934143
Marshall6351117
Dubois6291118
Cass6101112
Dearborn603578
Noble602090
Henry5969111
Jackson518077
Shelby511698
Lawrence4946127
Gibson464296
Montgomery460392
DeKalb457885
Clinton457455
Harrison456477
Huntington419382
Whitley417945
Steuben411760
Miami406773
Jasper402155
Knox390491
Putnam386062
Wabash370984
Adams354456
Ripley352371
Jefferson345387
White340754
Daviess3094100
Wells304581
Greene295585
Decatur293293
Fayette287164
Posey283135
Scott282358
LaGrange278172
Clay275649
Washington255337
Randolph247983
Jennings239949
Spencer239331
Fountain236550
Starke229959
Owen223859
Sullivan222143
Fulton209145
Jay203332
Carroll198522
Orange192356
Perry190639
Vermillion181544
Rush178327
Tipton173448
Franklin172935
Parke156116
Pike143034
Blackford138132
Pulaski123848
Newton123536
Benton109915
Brown106443
Crawford106216
Martin92515
Warren88015
Switzerland8468
Union73610
Ohio58511
Unassigned0429