Now that election excitement has died down, the attention of the politically obsessed has turned to speculation about who might be tapped to fill key leadership positions in President-Elect Barack Obama's Cabinet. For the sexual and reproductive health community, the past eight years has made it clear that we have to worry about much than just who fills the secretary position at the Health and Human Services.

First, it's important to remember exactly how bad the Bush years were for the sexual and reproductive health community. Tommy Thompson, Secretary of Health and Human Services during Bush's first term, advocated including "unborn children" in the state health insurance program. After Thompson departed, Bush appointed anti-choice Michael Leavitt to replace him, who recently proposed regulations that would "protect" doctors and nurses from providing abortion services and prescribing hormonal contraception. Let's not forget that Bush also temporarily appointed Susan Orr, of anti-birth control Family Research Council fame, to head up administering the nation's family planning program and before her Eric Keroack, someone with a history of opposing birth control, to be Deputy Assistant Secretary of Population Affairs at the Department of Health and Human Services. Keroack resigned a few months later after Medicaid filed a lawsuit against him. Andrew von Eschenbach, Bush's pick for commissioner of the Food and Drug Administration, opposed the over-the-sale approval of emergency contraception.  

Bush's shredding of women's health and rights extended beyond HHS. He signed the federal Partial-Birth Abortion Ban into law and appointed two judges that voted to uphold the legislation as constitutional. His attorney general, John Ashcroft subpoenaed thousands of women's medical records in its pursuit of upholding the ban. But Bush's influence over sexual and reproductive health wasn't just restricted to domestic policy. In addition to his war on birth control and other forms of contraception at home, Bush instituted a policy that prevented clinics abroad to discuss abortion with their patients or even accept pro-choice funding. This later became known as the Global Gag Rule.  

Given Bush's record, the Obama administration needs not only to undo eight years of damage in addition to taking bold strides on women's health issues.

Although we're just days from Obama's election, many are already speculating about who might fill the president-elect's positions on the highest levels. A few who have been suggested for the Health and Human Services secretary position: former South Dakota Sen. Tom Daschle, National Democratic Committee Chairman Howard Dean, and Kansas Gov. Kathleen Sebelius. This is potentially an important cabinet position if Obama is able to pass some kind of health care reform package, as the HHS secretary would be responsible for overseeing its implementation. All speculated candidates are pro-choice; Daschle and Sebelius have both been leaders in the health care reform movement.  

Daschle is clearly the favored choice, since he has made several policy proposals during his position as a senior fellow at the Center for American Progress. In a book released this year called Critical: What We Can Do About the Health-Care Crisis, Daschle proposed a Federal Health Board, an independent body for overseeing health care regulation, similar to how the Federal Reserve is situated to oversee economic regulation. 

Implementing policy that affects women isn't just confined to the Department of Health and Human Services. Since the secretary of state is also responsible for implementing many foreign aid packages that affect women's health, the position becomes vital to the advancement of sexual and reproductive health. Two of those Obama is said to be considering are Sen. Richard G. Lugar and Sen. Chuck Hagel. Both are Republicans that have earned a zero percent rating from NARAL Pro-Choice America. Democrats that Obama is likely considering are Sen. John Kerry and New Mexico Gov. Bill Richardson, who both ran on pro-choice platforms during their presidential campaigns. Kerry seems to be a leading candidate to fill the position.  

Those considered for attorney general are former Clinton Attorney General Eric Holder, Rep. Artur Davis, a socially conservative and anti-choice Southern Democrat, and Gov. Janet Napolitano, who has been congratulated by NARAL for protecting access to birth control in Arizona.  

Beth Fredrick, Executive Vice President for the International Women's Health Coalition, noted that while politicos speculate about individuals that might fill important positions, it is important to think about these various departments as working together. "[Discussions about who might fill cabinet positions] have been stratified between international and domestic appointments," Frederick said. "Department of State is seen as one category of important appointments for the international side and the Department of Health and the Department of Justice are seen as important for the domestic issues. Ideally we'd like to see candidates in both departments have the same kind of qualifications, similarly we'd like to see it cut across health and human rights."  

But it's not just departments that should think about working together. Frederick notes that there is an "opportunity between synergy for cabinet appointments and other appointments like World Bank and officials at the United Nations." Much of the work of State Department is tied to the work of international non-governmental organizations like the IMF and the World Bank, as well as an internationalist community like the United Nations. 

Frederick also notes that in a shrinking budget, she fears that funding for programs affecting women might be cut, and heads of programs or departments will be forced to make difficult choices about how to spend that money. She'd like to see reproductive and sexual health prioritized as these economic strains push more Americans onto government programs. "We need to invest our money wisely," she said. One way to do that is to ensure women have access to birth control and other preventative services. 

What is important is to remember how much damage appointees -- and not just cabinet members, but also lower level officials that might be called upon to administer specific programs -- can do if they don't have respect for women's health and sexuality. They can also do incredible good if they can manage the departments well. Obama's choices will resonate with women around the world for years to come.