1. United States
2. Ohio
3. Letter

I am writing to express serious concern about Bethany Kozma's appointment as director of the Department of Health and Human Services Office of Global Affairs. This position serves as the diplomatic voice of HHS, yet Kozma appears to lack any background in global health based on publicly available information. Her qualifications for this critical role remain unclear at a time when effective global health diplomacy is essential. Kozma's public record raises significant questions about her ability to represent American interests in global health negotiations. In August 2020, Senator Chris Coons and four other Democratic senators called for her removal from USAID, describing her as prejudiced and noting she had spoken extensively and derisively of transgender people. ProPublica obtained videos showing her calling gender-affirming care absolutely infuriating and describing the concept that gender is fluid as evil. She has also equated abortion with murder and characterized climate concerns as population control. These extreme positions directly contradict evidence-based public health approaches. LGBTQ populations face higher HIV risk, and policies that marginalize these communities can lead to increased infection rates. The Office of Global Affairs traditionally handles critical World Health Organization negotiations on pathogen surveillance and vaccine policy development. With the administration now pursuing bilateral health aid deals with individual countries, this role demands diplomatic skill and scientific credibility. Keifer Buckingham of the Council on Global Equality described Kozma as vehemently anti-trans, anti-LGBTQ, and anti-abortion, raising red flags about potential discrimination in U.S. foreign assistance. Musoba Kitui of Ipas Africa Alliance warns that aid cuts targeting LGBTQ health services could force desperate health systems to accept restrictive conditions that harm vulnerable populations. I urge you to oppose this appointment and advocate for leadership at the Office of Global Affairs with demonstrated expertise in global health and commitment to evidence-based policy that serves all populations.