In a week that saw the The President’s Commission on Combating Drug Addiction and the Opioid Crisis release a preliminary report urging President Trump to declare a state of national emergency due to the severity of the opioid epidemic, it was appropriate that the man responsible for combatting the largest injection drug use–related HIV outbreak in our nation’s history was confirmed as Surgeon General of the Public Health Service.

On Thursday, Dr. Jerome Adams, the Indiana State Health Commissioner who was responsible for leading the response to the outbreak of HIV linked to people who use injection drugs in rural Scott County, Indiana in 2015, was confirmed as the nation’s 20th Surgeon General. The confirmation came days after a nomination hearing before the U.S. Senate Committee on Health, Education, Labor and Pensions (HELP) for Dr. Adams and several other Trump administration nominations related to public health.

During what was largely a positive, congenial hearing, Dr. Adams spent a good deal of time discussing his takeaways from his experience with the HIV outbreak in Scott County and how he would try to apply that hard-won knowledge in the office of the Surgeon General:

“I think the biggest lesson that I learned, is that the science and the evidence is necessary, but it is not always sufficient to motivate change,” Dr. Adams told the HELP committee. He also stressed the need to “listen to what stakeholders are saying” in communities where public health crises are occurring and to tailor public health interventions to their needs and readiness for change. By way of demonstrating his commitment to this approach, Dr. Adams spoke about getting “a beer and a sandwich with the Sheriff” of Scott County during the height of the outbreak and allaying his fears about the creation of a syringe exchange program by stressing their importance as a contact point for engaging with people who inject drugs and, ultimately, getting them the treatment and care they need to lead healthy lives and stay out of the Sheriff’s jail.

Despite the good will expressed between Dr. Adams and the members of the HELP committee, the hearing was not without conflict and contentious remarks. Still justifiably upset at President Trump for his partisan dismissal of the previous Surgeon General, Dr. Vivek Murthy, HELP committee ranking member Senator Patty Murray (D-WA) chastised the Trump administration for showing a “lack of respect for that office and the independence of science.”

With his confirmation as Surgeon General, Dr. Adams becomes the latest in a growing list of former Indiana state officials appointed to significant public health positions by the Trump administration, joining Seema Verma, the current Administrator of the Centers for Medicare and Medicaid Services who was the principle architect of Indiana’s Medicaid program, and four former aides to Vice President Pence who now hold policy positions at the Department of Health and Human Services. And, while it is not uncommon for administrations to hire individuals with whom they already have working relationships, President Trump’s decision to populate his health care team with Hoosiers has raised a few eyebrows because of the fact that Indiana has consistently ranked in the bottom quartile of states in terms of overall health outcomes in recent years.

To learn more about Dr. Jerome Adams, his response to the HIV outbreak in Scott County, and AIDS United’s position on the nomination, you can read our Letter to the Senate HELP Committee on the matter.