Heading up the American dream of health

After a punishing 5-month confirmation process during which conservatives opposed to President Bill Clinton launched a series of accusations about the administrationʹs health policies, David A Satcher was sworn in on Feb 13 as the 16th US Surgeon General—a post vacant since Joycelyn Elders was abruptly fired in 1994. Satcher is also serving as Assistant Secretary for Health, the first time one person has filled both positions since the administration of President Jimmy Carter. Satcher, an African-American who grew up poor in the racially segregated south, trained as a family practitioner. He developed and later headed the King/Drew University Department of Family Medicine (Los Angeles, CA), and then became head of the Department of Community Medicine and Family Practice at Morehouse School of Medicine (Atlanta, GA) before moving to Nashville to serve for a decade as president of Tennesseeʹs Meharry Medical College. In 1993, Clinton appointed him director of the Centers for Disease Control and Prevention (CDC). During his confirmation battle for Surgeon General, conservative Christian groups criticised Satcher for CDCʹs role in a controversial study of short-term zidovudine (AZT) therapy to prevent perinatal transmission of HIV-1 in Africa, as well as for his support of Clintonʹs stand against a ban on a late-term abortion technique. Satcher, however, gained the enthusiastic support of the nationʹs medical community, including not only the American Medical Association, but also conservative Republican physicians in Congress.