Goats and Soda : NPR

Bethany Kozma is America's new top health diplomat.

The job she took on this week—to lead the Department of Health and Human Services' Office of Global Affairs—is not high profile. And Kozma herself is a little-known name in the world of healthcare.

But it's a position of power—and Kozma has a history of public speaking and activism on health issues, equating abortion with “murder” and opposing gender-affirming care.

The office is sometimes referred to as the “diplomatic voice” of HHS. As director, Kozma will have significant influence on how the U.S. shapes health policy in other countries following the Trump administration's cuts in foreign aid and withdrawal from the World Health Organization.

Kozma declined to be interviewed for this article. Based on publicly available information online, she appears to have no experience in global health. The HHS website provides few details about her professional profile. In response to questions about her qualifications and vision for the role, HHS responded with this statement.

“The Office of Global Affairs (OGA) advances the Trump Administration's agenda and priorities by bringing common sense, transparency, and gold-standard science to global partners. Under Secretary Kennedy's leadership, OGA is committed to strengthening the United States' position as the global gold standard for public health and ensuring the protection of Americans at home and abroad.”

Who is Bethany Kozma?

Kozma began her career in public service during the George W. Bush administration, serving on the White House Homeland Security Council. During the Obama years, she re-entered public life as an activist.

IN 2016 comment For Daily signalconservative news website founded by the Heritage Foundation, she opposed the Obama administration's guidance that public schools must allow children to use the bathroom that matches their identity.

“This radical agenda of subjective ‘gender fluidity’ and unlimited access to showers and baths actually puts everyone at risk,” she said, noting that “predators” could abuse the policy.

In 2017, she joined the Trump administration as a senior adviser for gender equality and women's empowerment at the U.S. Agency for International Development and was eventually promoted to deputy chief of staff. In the video received and released ProPublica writer Kozma recalls calling the US a pro-life country at a closed UN women's rights meeting in 2018, when access to abortion was still protected nationally Roe v. Wade.

In August 2020, Senator Chris Coons, D-Del., and four other Democratic senators released a letter calling Kozma and several other political appointees at USAID “biased” and called them be removed from their positions. Kozma “spoke at length and derisively about trans people and trans issues,” the senators wrote.

During the Biden administration, she also contributed to Project 2025, the new Republican administration's “blueprint” for the Heritage Foundation. She played a prominent role in the Project 2025 training videos. received and published from ProPublica.

In one almost 50-minute training video Focusing on left-wing speech, she called on the Republican administration to “eradicate references to 'climate change' from absolutely everywhere” and argued that concerns about climate change were an attempt at “population control.” She also called gender-affirming care “absolutely infuriating” and said that “the idea that gender is fluid is evil.” Overall, she argued that changing the language of these policies should be a priority for political appointees.

Kozma joined the second Trump administration as chief adviser to the HHS Office of Global Affairs. In September, she spoke at a UN event marking the 30th anniversary of the declaration that denial of women's rights is a violation of human rights.

“While many may rejoice at the so-called successes women have achieved over the past 30 years, the question must be asked, what determines true success for women?” she startedadding that “biological reality is rooted in scientific truth and confirmed by the universal truths endowed by our Creator, who created us ‘male and female’.”

These views may be divisive, but they have won some support for Kozma's promotion.

“Bethany is an excellent choice for the global affairs specialist at HHS,” says Roger ServinoVice President of Domestic Policy at The Heritage Foundation. “She was an early advocate for protecting children from gender ideology back when the medical establishment was able to silence voices of reason and dissent, and she is ideally placed to help push back against global health authorities attempting to impose pseudoscience on the American people and the world.”

What will her goals be in the Office of Global Affairs?

Kozma takes over as director of the HHS Office of Global Affairs at a time of dramatic change in global health.

Under previous administrations, the office's primary focus was working with the World Health Organization. Typically, the director, who typically has a public health background, is involved in negotiations such as data sharing for pathogen surveillance or vaccine policy development.

After President Trump the US withdrew From the WHO, the administration embarked on a new strategy: entering into agreements with individual countries to provide health care in exchange for their compliance with certain policy mandates. Kozma has been involved in some of these negotiations, but the details have not yet been finalized.

Some reproductive rights advocates believe Kozma will use his new position to include anti-abortion and anti-LGBTQ policies in those agreements.

“[Kozma] very anti-trans, anti-LGBTQI+, anti-abortion,” says Keifer Buckingham, managing director of the Council for Global Equality, a coalition of advocacy organizations focused on LGBTQ issues. [Kozma's appointment] raises a lot of red flags.”

Of particular concern is Helms AmendmentUS policy that prohibits the use of foreign aid to fund abortion services.

“There has been speculation that the US government intends to expand the Helms Amendment beyond abortion to also include LGBTQ people,” says Musoba KituiDirector of Ipas Africa Alliance, a non-profit organization that works to ensure access to abortion and contraception. He's concerned that health care groups serving these populations could lose funding. This assumption is confirmed by reports from Daily signal what the administration is planning ban US aid funding for “gender ideology and diversity, equity and inclusion initiatives.”

Given that the LGBT community is often at higher risk of contracting diseases such as HIV, such policies could make these communities even more vulnerable, Kitui says.

“We may see even greater marginalization, inequality, spikes in disease,” he says. While many of the African governments that have signed these agreements understand these dynamics, Kitui says they may still agree to more restrictive terms because aid cuts have “driven health systems to the point of desperation.”

Do you have information to share about current changes in federal health and development agencies? Contact Jonathan Lambert via encrypted communication on Signal: @jonlambert.12