From 1980 to 1994, Birx served as an active duty reserve officer in the
United States Army. From 1994 to 2008, Birx was active duty regular Army, achieving the rank of
Colonel. From 1986 to 1989, Birx worked at the
National Institutes of Health as an investigator specializing in cellular immunology.
CDC From 2005 to 2014, Birx served as the director of
Centers for Disease Control and Prevention's Division of Global HIV/AIDS (DGHA), part of the agency's Center for Global Health.
President's Emergency Plan for AIDS Relief In January 2014, President
Barack Obama nominated Birx to be the
Ambassador-at-Large and
U.S. Global AIDS Coordinator as part of the
President's Emergency Plan for AIDS Relief (PEPFAR) program. Birx was
confirmed by the Senate by
voice vote on April 2, 2014, and was sworn in two days later. She described her role as ambassador to help meet the
HIV prevention and treatment targets set by Obama in 2015 to end the
AIDS epidemic by 2030. Her role has focused on the areas of HIV/AIDS immunology, vaccine research, and global health issues around HIV/AIDS. PEPFAR management under Birx came under scrutiny in a February 2020 audit conducted by the State Department's Office of the Inspector General, with leadership of the program being described as "dictatorial", "directive" and "autocratic."
White House Coronavirus Task Force On February 27, 2020, Vice President
Mike Pence appointed Birx to the position of White House Coronavirus Response Coordinator. As part of this role, Birx reported to Pence on the
White House Coronavirus Task Force. Pence called her his "right arm" on the task force. In televised briefings, Birx interpreted data on the virus, urged the public to practice
social distancing, and tried to avoid publicly contradicting Trump, who frequently offered unscientific digressions. On March 26, 2020, Birx sought to reassure Americans in a press conference that "there is no situation in the United States right now that warrants that kind of discussion [that ventilators or ICU hospital beds might be in limited supply] ... You can be thinking about it ... but to say that to the American people, to make the implication that when they need a hospital bed, it's not going to be there, or when they need that ventilator, it's not going to be there, we don't have evidence of that right now." Birx led the creation of a reopening plan presented by Trump on April 16, 2020, with voluntary standards for states to end coronavirus lockdowns. During the state reopenings, Birx warned individuals to continue precautions against the virus, and opposed some non-essential activities such as professional haircuts. "You need to continue to social distance," she said on May 3, 2020. In July 2020, a working group convened by Birx ordered hospitals to bypass the
Centers for Disease Control and Prevention and instead send all COVID-19 patient information to a database at the
Department of Health and Human Services. Some health experts opposed the order and warned that the data might become politicized or withheld from the public. Birx, who had criticized hospitals and the CDC for being slow to gather data, helped select the data firm
Palantir to help run HHS's new system. She later joined Palantir's federal advisory board in 2022. On August 2, 2020, Birx recommended that people living with someone vulnerable to COVID-19 consider wearing masks at home. She said that the United States was in a "new phase" of the coronavirus epidemic that was "extraordinarily widespread". On August 10, 2020,
Scott Atlas joined the White House, becoming President Trump's top COVID-19 advisor. Afterward, Birx traveled to virus hot spots around the United States to work on mask mandates and social distancing guidelines with state and local officials. Birx visited Minnesota in August and October 2020. While in Minnesota, she told
Andy Slavitt that she hopes "the
election turns out a certain way." In November 2020, an internal report from Birx stated in bold font: "There is an absolute necessity of the Administration to use this moment to ask the American people to wear masks, physical distance and avoid gatherings in both public and private spaces." The report also stated that confronting an emerging wave of the pandemic required "an aggressive and balanced approach that is not being implemented". In December 2020, she warned that "The vaccine is critical, but it's not going to save us from this current surge", and that multiple approaches would be needed to fight the virus. Birx was alternately praised and pilloried by various sides, both for her responses as well as the actions in general of the CDC as well as the coronavirus task force. Critics alleged that Birx minimized the dangers of coronavirus and downplayed equipment shortfalls. She had been the White House's chief proponent for the idea in April that COVID-19 infections had peaked and the virus was fading quickly, when infections surged afterward. A board member at the
American College of Emergency Physicians, Ryan A. Stanton, said Birx sounded like “the builders of the
Titanic saying the ship can't sink". Birx was also accused of squandering her credibility and bringing her independence into question with her public praise of Trump, whom many believed bungled the coronavirus response. In December 2020, Birx indicated that she would retire from government soon after
Joe Biden assumed office, stating that she would "stay as long as needed and then retire" and that her tenure had "been a bit overwhelming" and was "very difficult on my family". Birx's announcement came after news broke that she hosted three generations of her own family from two households during Thanksgiving after she had urged Americans to restrict such gatherings to "your immediate household". On January 20, 2021, her term ended. Afterwards, Birx stated that she often considered quitting her position as White House coronavirus response coordinator under the Trump administration due to the administration's hyper-partisanship, especially during the
2020 presidential election. Birx also asserted that the Trump administration "censored" her "science-based guidance" and that she was also "being deliberately blocked" from appearing on national media outlets for a time. In a July 2022 interview with
Fox News, Birx said, "I think we overplayed the vaccines, and it made people then worry that it's not going to protect against severe disease and hospitalization. It will. But let's be very clear: 50% of the people who died from the Omicron surge were older, vaccinated. So that's why I'm saying even if you're vaccinated and boosted, if you're unvaccinated right now, the key is testing and
Paxlovid. It's effective. It's a great antiviral. And really, that is what's going to save your lives right now if you're over 70, which if you look at the hospitalizations, hospitalizations are rising steadily with new admissions, particularly in those over 70."
George W. Bush Institute In March 2021, Birx joined the
George W. Bush Institute in
Dallas,
Texas, as a senior fellow, working on initiatives to reduce
health disparities and prepare for future pandemics. ==Personal life==