National health policy: lessons from a hot seat

The author served as the nation's acquired immune deficiency syndrome (AIDS) policy coordinator from August 1993 to July 1994. Given the background of conflict surrounding human immunodeficiency virus (HIV) and AIDS policy in the United States, conflict about the position and function of a national policy coordinator is not surprising. This article discusses some of the expectations about the position, both positive and negative experiences, and lessons learned. The need for structural clarity, key staff backup, and clear agreement on timeliness is critical for anyone assuming a new, highly visible, politicized, ambiguous position.